HCPCS L0628
Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
Current codeLumbar Sacral Orthosis Brace26 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $24.42 – $205 | $14.40 | $36.00 |
| Deaconess Medical Center | $13.37 – $195 | $14.40 | $36.00 |
| Harborview Medical Center | $45.92 – $57.40 | $24.95 – $25.12 | $35.64 – $35.88 |
| Island Hospital | $142 – $160 | — | — |
| Kadlec Regional Medical Center | $48.50 – $152 | — | — |
| Mary Bridge Children's Hospital | $23.25 – $345 | $14.40 | $36.00 |
| MultiCare Auburn Medical Center | $23.74 – $203 | $14.40 | $36.00 |
| MultiCare Covington Medical Center | $23.74 – $203 | $14.40 | $36.00 |
| MultiCare Good Samaritan Hospital | $23.74 – $203 | $14.40 | $36.00 |
| MultiCare Valley Hospital | $13.37 – $195 | $14.40 | $36.00 |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $31.57 – $277 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $48.50 – $156 | — | — |
| Providence Centralia Hospital | $48.50 – $190 | — | — |
| Providence Regional Medical Center Everett | $34.44 – $180 | — | — |
| Providence St Peter Hospital | $24.40 – $254 | — | — |
| Seattle Children's Hospital | $23.17 – $41.18 | $42.90 | $42.90 |
| Swedish Edmonds Hospital | $43.05 – $369 | — | — |
| Swedish Issaquah | $43.05 – $213 | — | — |
| Swedish Medical Center | $43.05 – $213 | — | — |
| Swedish Medical Center / Cherry Hill | $43.05 – $255 | — | — |
| Tacoma General Allenmore Hospital | $23.74 – $203 | $14.40 | $36.00 |
| University of Washington Medical Ctr | $45.92 – $90.01 | $153 | $218 |
| Virginia Mason Medical Center | $27.13 – $130 | — | — |
| Wellfound Behavioral Health Hospital | $72.42 | — | — |
| Yakima Valley Memorial | $17.64 – $246 | $14.40 | $36.00 |
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
- $28.70 (fee)