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Shoulder Orthosis (SO), Vest Type Abduction Restrainer

Louisiana 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 $158 · 10th–90th $102$3470%20%10th90th$158Professionalmedian $105 · 10th–90th $78$1450%20%10th90th$105$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
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$104.71
Typical High
$147.91
BCBS
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$288.40
Typical High
$398.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$158.49
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$89.13
Typical High
$128.82