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Indiana rates for HCPCS L3675

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

Facilitymedian $195 · 10th–90th $95–$2400%50%10th90th$195Professionalmedian $100 · 10th–90th $81–$1700%20%40%10th90th$100$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
$95.50 / $95.50 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $97.72 / $169.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $194.98 / $245.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $107.15 / $190.55
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $107.15 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $169.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $107.15 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $95.50 / $138.04