go back

Missouri rates for HCPCS L3675

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

Facilitymedian $155 · 10th–90th $98–$3890%20%10th90th$155Professionalmedian $105 · 10th–90th $81–$2040%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $102.33 / $229.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $676.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $109.65 / $177.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $194.98
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 / $77.62 / $107.15
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $154.88 / $891.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $95.50 / $977.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $154.88 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $93.33 / $144.54