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Shoulder Orthosis (SO), Vest Type Abduction Restrainer

New Hampshire rates for HCPCS L3675

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

Rates data updated October 2026.

How much does Shoulder Orthosis (SO), Vest Type Abduction Restrainer cost?

$107

Typical negotiated rate. In New Hampshire, October 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $107 from a physician practice, and about $191 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$107$93.33 to $110
FacilityA hospital or hospital-owned outpatient department$191$174 to $209

How much rates vary

Facilitymedian $191 · 10th to 90th $107 to $234Professionalmedian $107 · 10th to 90th $78 to $166
$100$200facility $191professional $107

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$61.66
Typical High
$81.28
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$204.17
Typical High
$239.88
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$109.65
Typical High
$109.65
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Cigna
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$154.88
Cigna
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$77.62
Typical High
$107.15
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$165.96
Typical High
$269.15
United
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$93.33
Typical High
$151.36
Well Sense
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$186.21
Typical High
$186.21

Where New Hampshire sits

The same service costs 2.6 times more in Kansas than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 31st of 51

$107

KS $204DE $77.62

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.