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Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

Tennessee rates for HCPCS L3650

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

Rates data updated July 2026.

Facilitymedian $52 · 10th–90th $32$4270%20%40%10th90th$52Professionalmedian $34 · 10th–90th $29$580%20%10th90th$34$0.1$0.5$2.0$10.0$50.0$200.0

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
$29.51
Median
$32.36
Typical High
$457.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$33.88
Typical High
$57.54
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$85.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$52.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$56.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$46.77
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$562.34
Typical High
$562.34
United
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$38.02
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$32.36
Typical High
$47.86