HCPCS L0486

Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated

Current code29 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 L0486 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$1,867 – $14,48719 plans$1,104$2,761
Deaconess Medical CenterSpokaneFile dated 2026-08-27$1,026 – $9,01716 plans$1,104$2,761
Harborview Medical CenterSeattleFile dated 2026-04-01$3,467 – $4,3332 plans$2,654$3,792
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$3,267 – $6,0865 plans$3,414$4,877
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$1,783 – $15,90118 plans$1,104$2,761
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$1,815 – $9,36120 plans$1,104$2,761
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$1,815 – $9,36120 plans$1,104$2,761
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$1,815 – $9,36120 plans$1,104$2,761
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$1,026 – $8,99716 plans$1,104$2,761
Olympic Medical CenterPort AngelesFile dated 2026-06-24$30.74 – $55.006 plans$44.00$55.00
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$1,987 – $5,96110 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$3,356 – $7,1889 plans$3,850$5,499
Providence Centralia HospitalCentraliaFile dated 2026-04-01$3,662 – $8,1015 plans$6,318$12,150
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$3,850$5,499
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$3,676$5,251
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$2,600 – $5,0277 plans$6,389$12,286
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$3,676$5,251
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$3,580$5,115
Providence St Peter HospitalOlympiaFile dated 2026-04-01$1,842 – $7,0748 plans$6,318$12,150
Seattle Children's HospitalSeattle$4,558 – $8,10298 plans$8,440$8,440
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$3,250 – $7,9487 plans$3,719$7,749
Swedish IssaquahIssaquahFile dated 2026-04-01$3,250 – $4,8107 plans$2,434 – $3,719$5,070 – $7,749
Swedish Medical CenterSeattleFile dated 2026-04-01$3,250 – $7,7399 plans$2,434 – $3,719$5,070 – $7,749
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$3,250 – $7,7399 plans$2,434 – $3,719$5,070 – $7,749
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$1,815 – $9,36120 plans$1,104$2,761
University of Washington Medical CtrSeattleFile dated 2026-04-01$3,467 – $6,7955 plans$3,901$5,573
Virginia Mason Medical CenterSeattle$2,074 – $7,5357 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$5,4671 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$1,867 – $5,62113 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
$2,167 (fee)