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Shoulder Orthosis (SO), Vest Type Abduction Restrainer

Maine 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?

$110

Typical negotiated rate. In Maine, October 2026.

Insurers have agreed to pay about $110 for this service. Most negotiated rates run $95.50 to $166.

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 $234 · 10th to 90th $132 to $447Professionalmedian $110 · 10th to 90th $78 to $166
$100$200$500facility $234professional $110

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$114.82
Typical High
$114.82
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$239.88
Typical High
$446.68
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$109.65
Typical High
$117.49
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$10.72
Median
$10.72
Typical High
$11.75
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$79.43
Median
$79.43
Typical High
$87.10
Cigna
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$138.04
Cigna
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$77.62
Typical High
$107.15
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$165.96
Typical High
$213.80
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$89.13
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$93.33
Typical High
$263.03

Where Maine 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.

Maine· 27th of 51

$110

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.