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Shoulder Orthosis (SO), Vest Type Abduction Restrainer

South Carolina 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?

$102

Typical negotiated rate. In South Carolina, October 2026.

Insurers have agreed to pay about $102 for this service. The price depends on where it is billed: about $100 from a physician practice, and about $107 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$100$91.20 to $200
FacilityA hospital or hospital-owned outpatient department$107$100 to $200

How much rates vary

Facilitymedian $107 · 10th to 90th $95 to $200Professionalmedian $100 · 10th to 90th $87 to $200
$50$100$200$500facility $107professional $100

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
Facility
Modifier
None
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$95.50
Median
$95.50
Typical High
$169.82
BCBS South Carolina
Setting
Facility
Modifier
None
Typical Low
$177.83
Median
$199.53
Typical High
$199.53
BCBS South Carolina
Setting
Professional
Modifier
None (both parts)
Typical Low
$91.20
Median
$138.04
Typical High
$199.53
Cigna
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$154.88
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$77.62
Median
$77.62
Typical High
$123.03
Medcost
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$97.72
Typical High
$112.20
Medcost
Setting
Facility
Modifier
None
Typical Low
$54.95
Median
$107.15
Typical High
$239.88
Medcost
Setting
Professional
Modifier
None (both parts)
Typical Low
$107.15
Median
$138.04
Typical High
$257.04
Molina
Setting
Professional
Modifier
None (both parts)
Typical Low
$131.83
Median
$131.83
Typical High
$131.83
United
Setting
Facility
Modifier
None
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$66.07
Median
$93.33
Typical High
$117.49
8 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Medcost
Setting
Professional
Modifier
26 · Professional part
Typical Low
$56.23
Median
$57.54
Typical High
$138.04
Medcost
Setting
Professional
Modifier
50 · Both sides
Typical Low
$162.18
Median
$208.93
Typical High
$512.86
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$53.70
Median
$69.18
Typical High
$169.82
Medcost
Setting
Professional
Modifier
80 · Assistant surgeon
Typical Low
$21.38
Median
$27.54
Typical High
$69.18
Medcost
Setting
Professional
Modifier
81 · Minimal assistant surgeon
Typical Low
$15.14
Median
$19.50
Typical High
$47.86
Medcost
Setting
Professional
Modifier
82 · Assistant surgeon, no resident
Typical Low
$15.14
Median
$19.50
Typical High
$47.86
Medcost
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$15.14
Median
$19.50
Typical High
$47.86
Medcost
Setting
Professional
Modifier
TC · Technical part
Typical Low
$83.18
Median
$87.10
Typical High
$204.17

Where South Carolina 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.

South Carolina· 40th of 51

$102

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.