go back

Iowa rates for HCPCS L3675

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

Facilitymedian $186 · 10th–90th $95–$5500%10%10th90th$186Professionalmedian $112 · 10th–90th $78–$3240%20%10th90th$112$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $104.71 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $223.87 / $281.84
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $229.09
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $229.09 / $891.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $117.49 / $323.59
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $218.78 / $263.03
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $323.59 / $323.59
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $257.04 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $194.98 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $95.50 / $173.78
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $181.97