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Shoulder Orthosis (SO), Vest Type Abduction Restrainer

Hawaii rates for HCPCS L3675

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

Rates data updated October 2026.

How much does Shoulder Orthosis (SO), Vest Type Abduction Restrainer cost?

$191

Typical negotiated rate. In Hawaii, October 2026.

Insurers have agreed to pay about $191 for this service. Most negotiated rates run $148 to $200.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $148 · 10th to 90th $148 to $148Professionalmedian $191 · 10th to 90th $117 to $209
$100$200facility $148professional $191

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Cigna
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
HMSA
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$199.53
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$190.55
Typical High
$251.19
United
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$208.93
Typical High
$208.93
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$117.49
Typical High
$117.49

Where Hawaii sits

The same service costs 2.6 times more in Kansas than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Hawaii· 3rd of 51

$191

KS $204DE $77.62

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.