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Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

Virginia rates for HCPCS L3650

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

Rates data updated July 2026.

Facilitymedian $68 · 10th–90th $32$1000%20%10th90th$68Professionalmedian $40 · 10th–90th $31$720%20%10th90th$40$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
$25.70
Median
$37.15
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$37.15
Typical High
$57.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$81.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$83.18
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$52.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$46.77
Typical High
$46.77
Cigna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$46.77
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$75.86
Typical High
$107.15
Medcost
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$50.12
Typical High
$75.86
Medcost
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$48.98
Typical High
$87.10
Medcost
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$44.67
Typical High
$95.50
Sentara
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$63.10
Typical High
$218.78
Sentara
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$63.10
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$34.67
Typical High
$89.13
United
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$37.15
Typical High
$61.66