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Pennsylvania rates for HCPCS L3650

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

Facilitymedian $34 · 10th–90th $11–$1290%10%10th90th$34Professionalmedian $39 · 10th–90th $30–$1170%20%40%10th90th$39$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $32.36 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.90 / $117.49
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $50.12
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $100.00 / $144.54
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $53.70 / $75.86
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $162.18 / $436.52
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $60.26
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $37.15 / $66.07
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.90 / $57.54
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $117.49
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $53.70 / $70.79
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $75.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $89.13 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $37.15 / $75.86