go back

New Hampshire rates for HCPCS L3675

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

Facilitymedian $191 · 10th–90th $62–$2290%10%20%10th90th$191Professionalmedian $117 · 10th–90th $74–$1780%20%10th90th$117$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
$61.66 / $61.66 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $81.28 / $162.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $204.17 / $234.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $109.65
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $85.11 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $112.20 / $165.96
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $269.15