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Ohio rates for HCPCS L3675

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

Facilitymedian $209 · 10th–90th $102$4470%20%10th90th$209Professionalmedian $102 · 10th–90th $78$1740%20%10th90th$102$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
$102.33 / $147.91 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $97.72 / $154.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $208.93 / $416.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $114.82 / $257.04
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $165.96 / $234.42
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $173.78 / $263.03
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 / $120.23
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $154.88
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $107.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $138.04 / $194.98
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $218.78 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $158.49 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $91.20 / $131.83