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Shoulder Orthosis (SO), Airplane Design, Custom Fabricated

Maine rates for HCPCS L3674

Shoulder orthosis (SO), abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Rates data updated July 2026.

How much does Shoulder Orthosis (SO), Airplane Design, Custom Fabricated cost?

$776

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $776 for this service. The price depends on where it is billed: about $776 from a physician practice, and about $1,479 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$776$692 to $1,096
FacilityA hospital or hospital-owned outpatient department$1,479$741 to $1,514

How much rates vary

Facilitymedian $1,479 · 10th to 90th $724 to $1,698Professionalmedian $776 · 10th to 90th $550 to $1,096
$500$1K$2Kfacility $1,479professional $776

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$691.83
Typical High
$794.33
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,513.56
Typical High
$1,698.24
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$776.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$724.44
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,318.26
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$741.31
Typical High
$794.33
United
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$575.44
Typical High
$741.31
United
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$1,096.48
Typical High
$1,096.48

Where Maine sits

The same service costs 2.6 times more in Kansas than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maine· 19th of 51

$776

KS $1,349DC $513

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.