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Nebraska rates for HCPCS L3675

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

Facilitymedian $200 · 10th–90th $85–$8910%20%10th90th$200Professionalmedian $129 · 10th–90th $78–$3550%10%10th90th$129$100.0$200.0$500.0$1.0K

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
$123.03 / $123.03 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $158.49 / $354.81
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $165.96 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $186.21 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $154.88 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $223.87 / $331.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $208.93 / $891.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $95.50 / $204.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $512.86
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $478.63 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $102.33 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $95.50 / $151.36