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Texas rates for HCPCS L3675

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

Facilitymedian $148 · 10th–90th $85–$3890%10%10th90th$148Professionalmedian $91 · 10th–90th $72–$1410%50%10th90th$91$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$85.11 / $89.13 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $89.13 / $154.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $147.91 / $181.97
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $199.53 / $199.53
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 / $107.15
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,412.54 / $1,412.54
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $151.36 / $251.19
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $91.20 / $199.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $123.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $144.54 / $251.19
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $107.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $134.90 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $102.33 / $123.03
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $199.53 / $199.53