HCPCS L0458

Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment

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 L0458 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$922 – $7,15319 plans$545$1,363
Deaconess Medical CenterSpokaneFile dated 2026-08-27$506 – $4,45216 plans$545$1,363
Harborview Medical CenterSeattleFile dated 2026-04-01$1,712 – $2,1402 plans$1,310$1,872
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$1,613 – $3,0055 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$880 – $7,85118 plans$545$1,363
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$896 – $4,62220 plans$545$1,363
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$896 – $4,62220 plans$545$1,363
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$896 – $4,62220 plans$545$1,363
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$506 – $4,44216 plans$545$1,363
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$981 – $2,94310 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$1,657 – $3,5499 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$1,808 – $4,0005 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$1,284 – $2,4827 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$909 – $3,4938 plans——
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$1,605 – $3,9247 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$1,605 – $2,3757 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$1,605 – $3,8219 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$1,605 – $3,8219 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$896 – $4,62220 plans$545$1,363
University of Washington Medical CtrSeattleFile dated 2026-04-01$1,712 – $3,3555 plans$1,740$2,486
Virginia Mason Medical CenterSeattle$1,024 – $3,7207 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$2,7001 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$668 – $2,77519 plans$545$1,363

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
$1,070 (fee)