Prefabricated figure-eight shoulder abduction brace

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC Splnt Clvcl 48-54in 2xl

Payers reporting HCPCS L3650

Payer pricing summary

Low

Average

$112

Median

$73

High

$920

Payer rate distribution

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#
1	Wellmark case rate · outpatient · +12 other terms	13	$79	$58	$40	69%	42–60	$19 – $172
2	Bcbs Al other · outpatient · +1 other terms	1	$13	$13	—	—	2–20	$13 – $13
3	UnitedHealthcare fee schedule · outpatient · +27 other terms	467	$72	$69	$55	80%	—	$1 – $588
4	Aetna fee schedule · outpatient · +25 other terms	403	$74	$101	$99	98%	—	$1 – $685
5	Humana fee schedule · outpatient · +22 other terms	347	$72	$101	$115	114%	—	$5 – $693
6	Blue Cross Blue Shield fee schedule · outpatient · +27 other terms	291	$73	$99	$66	67%	—	$0 – $1.0k
7	WellCare fee schedule · outpatient · +14 other terms	213	$75	$77	$17	22%	—	$22 – $231
8	Molina fee schedule · outpatient · +19 other terms	161	$84	$85	$37	43%	—	$1 – $191
9	Devoted fee schedule · outpatient · +9 other terms	159	$67	$72	$4	5%	—	$64 – $91
10	Cigna fee schedule · outpatient · +24 other terms	153	$73	$88	$76	86%	—	$3 – $355
11	Cigna Healthspring fee schedule · outpatient · +4 other terms	116	$72	$73	$4	5%	—	$67 – $92
12	Anthem fee schedule · outpatient · +20 other terms	115	$67	$69	$89	129%	—	$4 – $605
13	Kaiser fee schedule · outpatient · +19 other terms	104	$68	$123	$104	84%	—	$5 – $522
14	MultiPlan fee schedule · outpatient · +16 other terms	77	$38	$91	$110	120%	—	$6 – $525
15	Ambetter facility · fee schedule · outpatient · +16 other terms	52	$126	$118	$38	32%	—	$0 – $174
16	Caresource fee schedule · outpatient · +14 other terms	50	$68	$82	$33	40%	—	$37 – $322
17	Superior Healthplan fee schedule · outpatient · +3 other terms	43	$77	$71	$18	25%	—	$8 – $86
18	Clover fee schedule · outpatient · +4 other terms	42	$75	$74	$4	6%	—	$67 – $89
19	Tricare facility · fee schedule · outpatient · +14 other terms	39	$64	$53	$23	44%	—	$5 – $113
20	Medica fee schedule · outpatient · +15 other terms	36	$86	$80	$66	82%	—	$7 – $202
21	Optum fee schedule · outpatient · +14 other terms	36	$66	$66	$47	71%	—	$7 – $183
22	Oscar fee schedule · outpatient · +12 other terms	36	$72	$86	$26	30%	—	$71 – $151
23	First Health fee schedule · outpatient · +15 other terms	34	$59	$108	$100	92%	—	$15 – $396
24	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$175	$132	$54	41%	—	$29 – $205
25	Medicare fee schedule · outpatient · +10 other terms	25	$64	$65	$2	3%	—	$64 – $76

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