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Alaska rates for HCPCS L3675

Shoulder orthosis (SO), vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf

Facilitymedian $107 · 10th–90th $55–$2000%20%40%10th90th$107Professionalmedian $115 · 10th–90th $55–$2340%10%10th90th$115$100.0$200.0$500.0

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
$275.42 / $275.42 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $112.20 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $208.93
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $138.04 / $190.55
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $181.97 / $616.60
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $181.97 / $190.55
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $181.97 / $190.55
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $199.53
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $107.15 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $131.83 / $467.74