go back

Shoulder Orthosis (SO), Vest Type Abduction Restrainer

Virginia 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 $191 · 10th–90th $93$2400%20%40%10th90th$191Professionalmedian $98 · 10th–90th $78$1820%20%10th90th$98$0.2$2.0$20.0$200.0$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
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$93.33
Typical High
$93.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$93.33
Typical High
$104.71
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$204.17
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$223.87
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$131.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$107.15
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$107.15
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$190.55
Typical High
$269.15
Medcost
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$125.89
Typical High
$186.21
Medcost
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$123.03
Typical High
$218.78
Medcost
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$114.82
Typical High
$239.88
Sentara
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$158.49
Typical High
$549.54
Sentara
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$158.49
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$85.11
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$93.33
Typical High
$151.36