HCPCS L0623
Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf
Current code25 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 | $59.19 – $65.11 | $30.40 | $76.00 |
| Deaconess Medical Center | $59.19 – $65.11 | $30.40 | $76.00 |
| Harborview Medical Center | $60.40 – $66.44 | — | — |
| Island Hospital | $187 – $198 | — | — |
| Kadlec Regional Medical Center | $60.40 – $72.48 | — | — |
| Mary Bridge Children's Hospital | $59.19 – $65.11 | $30.40 | $76.00 |
| MultiCare Auburn Medical Center | $59.19 – $65.11 | $30.40 | $76.00 |
| MultiCare Covington Medical Center | $59.19 – $65.11 | $30.40 | $76.00 |
| MultiCare Good Samaritan Hospital | $59.19 – $65.11 | $30.40 | $76.00 |
| MultiCare Valley Hospital | $60.97 – $65.11 | $30.40 | $76.00 |
| Olympic Medical Center | $196 – $253 | — | — |
| Overlake Hospital Medical Center & Clinics | $60.40 – $62.82 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $60.40 – $72.48 | — | — |
| Providence Centralia Hospital | $60.40 – $96.64 | — | — |
| Providence Regional Medical Center Everett | $60.40 – $66.44 | — | — |
| Providence St Peter Hospital | $60.40 – $96.64 | — | — |
| Swedish Edmonds Hospital | $60.40 – $72.48 | — | — |
| Swedish Issaquah | $60.40 – $72.48 | — | — |
| Swedish Medical Center | $60.40 – $72.48 | — | — |
| Swedish Medical Center / Cherry Hill | $60.40 – $72.48 | — | — |
| Tacoma General Allenmore Hospital | $59.19 – $65.11 | $30.40 | $76.00 |
| University of Washington Medical Ctr | $60.40 – $66.44 | — | — |
| Virginia Mason Medical Center | $41.17 – $61.76 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $59.19 – $66.30 | $30.40 | $76.00 |
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
- $60.40 (fee)