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South Carolina rates for HCPCS L3675

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

Facilitymedian $115 · 10th–90th $87–$2510%10%20%10th90th$115Professionalmedian $100 · 10th–90th $81–$1740%20%10th90th$100$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $100.00 / $173.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $186.21 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $107.15 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $223.87
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $112.20
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $144.54 / $302.00
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $131.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $102.33 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $95.50 / $128.82