go back

Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

New York rates for HCPCS L3650

Shoulder orthosis (SO), figure of eight design abduction restrainer, prefabricated, off-the-shelf

Rates data updated July 2026.

Facilitymedian $48 · 10th–90th $26$1120%20%10th90th$48Professionalmedian $41 · 10th–90th $32$1170%20%10th90th$41$0.1$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$47.86
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$39.81
Typical High
$117.49
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$154.88
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$40.74
Typical High
$128.82
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$63.10
Typical High
$63.10
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$50.12
Typical High
$104.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$79.43
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$125.89
Typical High
$295.12
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$75.86
Typical High
$144.54
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$40.74
Typical High
$42.66
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$43.65
Typical High
$45.71
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$74.13
Typical High
$87.10
United
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$38.02
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$50.12
Typical High
$125.89
Univera
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$43.65
Typical High
$46.77
Univera
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$43.65
Typical High
$45.71