HCPCS L0492 at Providence St Peter Hospital

Tlso, sagittal-coronal control, modular segmented spinal system, three 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

Providence St Peter Hospital, Olympia

Description from CMS's HCPCS Level II code file.

What Providence St Peter Hospital publishes for this code: as an outpatient

Providence St Peter Hospital’s prices for HCPCS L0492, as an outpatient
Who paysHospital’s fee (lowest – highest)Doctor’s fee the hospital lists
Commercial insuranceInsurer rates$515 – $1,9788 plans—
Medicare AdvantageInsurer rates$606 – $9697 plans—
Cash pricePaying yourself, without insurance——
List priceBefore any discount; few people pay it——

Lowest and highest amounts Providence St Peter Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-04-01. 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 the rest of Washington 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 L0492 at Providence St Peter Hospital
BillWhat it’s forOriginal Medicare allowsPrivate plan estimate
Hospital's feeThe hospitalThe 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 L0492 at every Washington hospital, with Medicare’s reference amounts.