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Michigan rates for HCPCS L3675

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

Facilitymedian $363 · 10th–90th $107–$7080%20%10th90th$363Professionalmedian $107 · 10th–90th $76–$1910%20%10th90th$107$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$109.65 / $363.08 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $97.72 / $144.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $575.44 / $1,096.48
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $199.53
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $107.15 / $213.80
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $363.08 / $407.38
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $154.88 / $234.42
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $154.88
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $158.49 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $158.49 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $91.20 / $134.90