go back

Shoulder Orthosis (SO), Vest Type Abduction Restrainer

Arizona rates for HCPCS L3675

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

Rates data updated July 2026.

Facilitymedian $162 · 10th–90th $55$3890%10%10th90th$162Professionalmedian $85 · 10th–90th $55$2290%20%10th90th$85$0.2$1.0$5.0$20.0$100.0$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
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$85.11
Typical High
$234.42
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$213.80
Typical High
$407.38
BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$194.98
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$107.15
Medica
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$131.83
Typical High
$891.25
Medica
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$85.11
Typical High
$977.24
United
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$154.88
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$85.11
Typical High
$128.82