HCPCS L0491 at Virginia Mason Medical Center

Tlso, sagittal-coronal 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 and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment

Virginia Mason Medical Center, Seattle

Description from CMS's HCPCS Level II code file.

What Virginia Mason Medical Center publishes for this code: as an outpatient

Virginia Mason Medical Center’s prices for HCPCS L0491, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$882 – $3,2047 plans	—
Medicare AdvantageInsurer rates	$632 – $9489 plans	—
Cash pricePaying yourself, without insurance	—	—
List priceBefore any discount; few people pay it	—	—

Lowest and highest amounts Virginia Mason Medical Center lists for this code as an outpatient, including lines it lists for both settings or without saying which. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in Seattle (King County) for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS L0491 at Virginia Mason Medical Center
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The service	—	The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS L0491 at every Washington hospital, with Medicare’s reference amounts.