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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

Facilitymedian $724 · 10th–90th $479–$1,3180%20%40%10th90th$724Professionalmedian $891 · 10th–90th $479–$5,4950%10%10th90th$891$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $741.31 / $5,495.41
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $724.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $954.99 / $1,230.27
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,318.26 / $1,318.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $933.25 / $1,412.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,318.26 / $1,348.96
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,348.96 / $1,548.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $575.44 / $758.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $575.44 / $977.24