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Washington rates for HCPCS L3670

Shoulder orthosis (SO), acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf

Facilitymedian $129 · 10th–90th $87–$2880%10%20%10th90th$129Professionalmedian $89 · 10th–90th $40–$2190%5%10th90th$89$1.0$5.0$20.0$100.0$500.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $97.72 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $77.62 / $213.80
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $125.89 / $138.04
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $125.89 / $125.89
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $87.10
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $177.83 / $363.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $162.18 / $288.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $100.00 / $109.65
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $125.89 / $128.82
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $125.89 / $147.91
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $257.04
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $125.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $144.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $169.82 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $72.44 / $117.49
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $93.33 / $199.53