go back

Washington rates for HCPCS L3675

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

Facilitymedian $191 · 10th–90th $117–$4570%20%10th90th$191Professionalmedian $126 · 10th–90th $76–$2750%10%20%10th90th$126$1.0$5.0$20.0$100.0$500.0

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
$18.20 / $125.89 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $102.33 / $204.17
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $181.97 / $181.97
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $208.93
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $239.88 / $524.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $223.87 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $186.21 / $190.55
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $186.21 / $190.55
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $275.42 / $371.54
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $181.97
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $281.84 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $93.33 / $162.18
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $134.90 / $288.40