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Shoulder Orthosis (SO), Vest Type Abduction Restrainer

Utah 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?

$107

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $107 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$107$77.62 to $141
FacilityA hospital or hospital-owned outpatient department$107$54.95 to $195

How much rates vary

Facilitymedian $107 · 10th to 90th $55 to $195Professionalmedian $107 · 10th to 90th $55 to $178
$100$200facility $107professional $107

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
$54.95
Median
$54.95
Typical High
$54.95
Aetna
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Cigna
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Cigna
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$77.62
Typical High
$107.15
Molina
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$141.25
Typical High
$186.21
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$194.98
Typical High
$295.12
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Select Health
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Select Health
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$190.55
Typical High
$199.53
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$158.49
Typical High
$229.09
United
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$85.11
Typical High
$154.88

Where Utah 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.

Utah· 34th of 51

$107

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.