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Shoulder Orthosis (SO), Airplane Design, Custom Fabricated

Tennessee 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?

$631

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $631 for this service. The price depends on where it is billed: about $617 from a physician practice, and about $912 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 5 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$617$589 to $759
FacilityA hospital or hospital-owned outpatient department$912$646 to $6,166

How much rates vary

Facilitymedian $912 · 10th to 90th $575 to $6,166Professionalmedian $617 · 10th to 90th $550 to $1,096
$500$1K$2K$5K$10Kfacility $912professional $617

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$645.65
Typical High
$1,023.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$616.60
Typical High
$1,096.48
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,047.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$724.44
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$6,165.95
Median
$6,165.95
Typical High
$6,165.95
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$6,606.93
Median
$9,549.93
Typical High
$9,549.93
United
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$676.08
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$630.96
Typical High
$870.96

Where Tennessee 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.

Tennessee· 42nd of 51

$631

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.