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Montana 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

Facilitymedian $1,288 · 10th–90th $851–$1,5850%20%40%10th90th$1,288Professionalmedian $759 · 10th–90th $479–$1,5850%10%10th90th$759$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $741.31 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,380.38 / $1,380.38
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,288.25 / $2,511.89
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,288.25 / $2,511.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,288.25 / $1,513.56
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,023.29 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $758.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $575.44 / $912.01