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Washington 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 $1,380 · 10th–90th $1,023–$3,3110%10%20%10th90th$1,380Professionalmedian $851 · 10th–90th $550–$1,9050%10%20%10th90th$851$1.0$5.0$20.0$100.0$500.0$2.0K$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
$851.14 / $851.14 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $691.83 / $1,148.15
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,230.27 / $1,230.27
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,412.54
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,995.26 / $3,801.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,819.70 / $2,951.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $977.24 / $1,071.52
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,258.93 / $1,288.25
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,905.46 / $2,511.89
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,230.27
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,905.46 / $1,905.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $630.96 / $1,096.48
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $912.01 / $1,949.84