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Shoulder Orthosis (SO), Vest Type Abduction Restrainer

Pennsylvania 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.

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

$91.20

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $91.20 for this service. The price depends on where it is billed: about $91.20 from a physician practice, and about $302 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$91.20$77.62 to $117
FacilityA hospital or hospital-owned outpatient department$302$85.11 to $589

How much rates vary

Facilitymedian $302 · 10th to 90th $78 to $1,000Professionalmedian $91 · 10th to 90th $66 to $186
$1.0$10.0$100.0$1.0K$10.0Kfacility $302professional $91

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$302.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$91.20
Typical High
$134.90
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$112.20
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$363.08
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$134.90
Typical High
$190.55
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$870.96
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$141.25
Typical High
$245.47
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$302.00
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$91.20
Typical High
$154.88
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$676.08
Typical High
$1,096.48
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$177.83
Typical High
$181.97
United
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$234.42
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$93.33
Typical High
$194.98

Where Pennsylvania sits

The same service costs 3.5 times more in Kansas than in Vermont. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $91.20 · 39th of 51
KS $214VT $61.66

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.