go back

Pennsylvania 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 $1,585 · 10th–90th $525$1,9950%20%10th90th$1,585Professionalmedian $646 · 10th–90th $525$1,1750%20%10th90th$646$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,995.26 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $645.65 / $954.99
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $724.44
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,698.24 / $2,454.71
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $912.01 / $1,288.25
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $645.65 / $891.25
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $1,819.70 / $2,511.89
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,202.26
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,584.89 / $1,819.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $630.96 / $1,288.25