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Shoulder Orthosis (SO), Vest Type Abduction Restrainer

Rhode Island 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 $339 · 10th–90th $105$4370%10%20%10th90th$339Professionalmedian $91 · 10th–90th $66$1290%10%20%10th90th$91$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$81.28
Typical High
$109.65
BCBS
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$371.54
Typical High
$436.52
BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
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
$77.62
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$104.71
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$100.00
Typical High
$154.88