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Minnesota rates for HCPCS L3675

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

Facilitymedian $214 · 10th–90th $155–$1,4130%20%10th90th$214Professionalmedian $191 · 10th–90th $95–$2240%50%10th90th$191$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
$131.83 / $131.83 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $112.20 / $169.82
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $190.55 / $251.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $190.55 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $724.44 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $257.04 / $281.84
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $707.95 / $1,412.54
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $302.00
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $190.55 / $891.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $87.10 / $234.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $85.11 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $100.00 / $269.15