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Shoulder Orthosis (SO), Vest Type Abduction Restrainer

New Mexico rates for HCPCS L3675

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

Rates data updated July 2026.

Facilitymedian $123 · 10th–90th $55$2000%10%10th90th$123Professionalmedian $115 · 10th–90th $55$2040%10%20%10th90th$115$100.0$200.0$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
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$95.50
Typical High
$812.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$154.88
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$281.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$194.98
Typical High
$288.40
Providence
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$138.04
Typical High
$199.53
Providence
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$194.98
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$93.33
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$128.82