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Shoulder Orthosis (SO), Airplane Design, Custom Fabricated

Utah 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?

$724

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $724 for this service. The price depends on where it is billed: about $724 from a physician practice, and about $575 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 7 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$724$525 to $1,349
FacilityA hospital or hospital-owned outpatient department$575$479 to $1,318

How much rates vary

Facilitymedian $575 · 10th to 90th $479 to $1,318Professionalmedian $724 · 10th to 90th $437 to $5,495
$500$1K$2K$5Kfacility $575professional $724

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
$478.63
Median
$478.63
Typical High
$478.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$575.44
Typical High
$5,495.41
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
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$954.99
Typical High
$1,230.27
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,318.26
Typical High
$1,318.26
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$933.25
Typical High
$1,412.54
Select Health
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$1,348.96
Select Health
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$1,288.25
Typical High
$1,348.96
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,348.96
Typical High
$1,548.82
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$575.44
Typical High
$1,202.26
United
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$575.44
Typical High
$933.25

Where Utah 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.

Utah· 29th of 51

$724

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.