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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 October 2026.

How much does Shoulder Orthosis (SO), Vest Type Abduction Restrainer cost?

$107

Typical negotiated rate. In Virginia, 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 $151 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$107$93.33 to $120
FacilityA hospital or hospital-owned outpatient department$151$107 to $191

How much rates vary

Facilitymedian $151 · 10th to 90th $93 to $288Professionalmedian $107 · 10th to 90th $78 to $158
$100$200$500$1K$2K$5K$10Kfacility $151professional $107

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$77.62
Median
$93.33
Typical High
$93.33
Aetna
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$93.33
Typical High
$102.33
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$204.17
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$120.23
CareFirst
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$104.71
Typical High
$131.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$83.18
Median
$107.15
Typical High
$154.88
Cigna
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$77.62
Typical High
$107.15
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$190.55
Typical High
$251.19
Medcost
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$125.89
Typical High
$173.78
Medcost
Setting
Facility
Modifier
None
Typical Low
$60.26
Median
$102.33
Typical High
$125.89
Medcost
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$114.82
Typical High
$239.88
Sentara
Setting
Facility
Modifier
None
Typical Low
$93.33
Median
$134.90
Typical High
$407.38
Sentara
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$141.25
Typical High
$288.40
United
Setting
Facility
Modifier
None
Typical Low
$234.42
Median
$234.42
Typical High
$281.84
United
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$93.33
Typical High
$141.25
2 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
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$10.96
Median
$10.96
Typical High
$13.49
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$79.43
Median
$81.28
Typical High
$85.11

Where Virginia 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.

Virginia· 30th 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.