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Wisconsin 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 $1,318 · 10th–90th $1,230$2,3990%50%10th90th$1,318Professionalmedian $851 · 10th–90th $575$1,9950%20%10th90th$851$1.0$5.0$20.0$100.0$500.0$2.0K

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
$645.65 / $645.65 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $645.65 / $954.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $2,187.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,230.27 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $3,019.95 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $1,862.09 / $2,511.89
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,071.52 / $1,548.82
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,288.25 / $1,584.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,288.25 / $6,025.60
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $691.83 / $1,479.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $758.58
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,089.30
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,548.82 / $2,570.40
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,995.26 / $3,630.78
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,630.27 / $6,025.60
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $1,047.13 / $6,456.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $676.08 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $645.65 / $1,096.48