HCPCS L0621
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf
Current code32 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $17.20 – $241 | $43.00 – $603 |
| Deaconess Medical Center | — | $17.20 – $241 | $43.00 – $603 |
| Harborview Medical Center | — | $29.28 | $41.83 |
| Kadlec Regional Medical Center | — | $98.70 | $141 |
| Mary Bridge Children's Hospital | — | $17.20 – $241 | $43.00 – $603 |
| MultiCare Auburn Medical Center | — | $17.20 – $241 | $43.00 – $603 |
| MultiCare Covington Medical Center | — | $17.20 – $241 | $43.00 – $603 |
| MultiCare Good Samaritan Hospital | — | $17.20 – $241 | $43.00 – $603 |
| MultiCare Valley Hospital | — | $17.20 – $241 | $43.00 – $603 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $212 | $303 |
| Providence Centralia Hospital | — | $125 | $240 |
| Providence Holy Family Hospital | — | $212 | $303 |
| Providence Mount Carmel Hospital | — | $200 | $285 |
| Providence Regional Medical Center Everett | — | $133 | $255 |
| Providence St Joseph Hospital | — | $200 | $285 |
| Providence St Mary Medical Center | — | $126 | $180 |
| Providence St Peter Hospital | — | $125 | $240 |
| Seattle Children's Hospital | — | $167 | $167 |
| Swedish Edmonds Hospital | — | $82.08 – $92.75 | $171 – $193 |
| Swedish Issaquah | — | $82.08 – $92.75 | $171 – $193 |
| Swedish Medical Center | — | $82.08 – $92.75 | $171 – $193 |
| Swedish Medical Center / Cherry Hill | — | $82.08 – $92.75 | $171 – $193 |
| Tacoma General Allenmore Hospital | — | $17.20 – $241 | $43.00 – $603 |
| University of Washington Medical Ctr | — | $209 | $298 |
| Yakima Valley Memorial | — | $17.20 – $156 | $43.00 – $391 |
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
- $33.70 (fee)