HCPCS L0454

Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Current code23 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS L0454 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$358 – $2,78219 plans$207$518
Deaconess Medical CenterSpokaneFile dated 2026-08-27$192 – $1,73116 plans$207$518
Harborview Medical CenterSeattleFile dated 2026-04-01$666 – $8322 plans$510$728
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$627 – $1,1695 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$335 – $3,05318 plans$207$518
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$349 – $1,79720 plans$207$518
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$349 – $1,79720 plans$207$518
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$349 – $1,79720 plans$207$518
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$192 – $1,72716 plans$207$518
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$382 – $1,14510 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$644 – $1,3809 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$703 – $1,5555 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$499 – $9657 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$354 – $1,3588 plans——
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$624 – $1,5267 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$624 – $9247 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$624 – $1,4869 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$624 – $1,4869 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$349 – $1,79720 plans$207$518
University of Washington Medical CtrSeattleFile dated 2026-04-01$666 – $1,3055 plans$676$966
Virginia Mason Medical CenterSeattle$398 – $1,4477 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$1,0501 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$358 – $1,07913 plans——

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Equipment fee, Washington
$416 (fee)