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Wisconsin rates for HCPCS L3671

Shoulder orthosis (SO), shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $1,000 · 10th–90th $891–$1,8200%50%10th90th$1,000Professionalmedian $646 · 10th–90th $447–$1,5140%10%20%10th90th$646$1.0$5.0$20.0$100.0$500.0$2.0K

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
$501.19 / $501.19 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $501.19 / $724.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,659.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $933.25 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $2,344.23 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,445.44 / $1,905.46
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $812.83 / $1,258.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $954.99 / $1,202.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $977.24 / $4,570.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $524.81 / $1,096.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $645.65
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,148.15 / $1,995.26
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,513.56 / $2,754.23
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $1,995.26 / $4,570.88
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $812.83 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $512.86 / $1,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $489.78 / $831.76