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
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 | $28.13 – $30.94 | $14.40 | $36.00 |
| Deaconess Medical Center | $28.13 – $30.94 | $14.40 | $36.00 |
| Harborview Medical Center | $28.70 – $31.57 | $24.95 – $25.12 | $35.64 – $35.88 |
| Island Hospital | $88.79 – $94.12 | — | — |
| Kadlec Regional Medical Center | $28.70 – $34.44 | — | — |
| Mary Bridge Children's Hospital | $28.13 – $30.94 | $14.40 | $36.00 |
| MultiCare Auburn Medical Center | $28.13 – $30.94 | $14.40 | $36.00 |
| MultiCare Covington Medical Center | $28.13 – $30.94 | $14.40 | $36.00 |
| MultiCare Good Samaritan Hospital | $28.13 – $30.94 | $14.40 | $36.00 |
| MultiCare Valley Hospital | $28.97 – $30.94 | $14.40 | $36.00 |
| Olympic Medical Center | $93.23 – $120 | — | — |
| Overlake Hospital Medical Center & Clinics | $28.70 – $29.85 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $28.70 – $34.44 | — | — |
| Providence Centralia Hospital | $28.70 – $45.92 | — | — |
| Providence Regional Medical Center Everett | $28.70 – $31.57 | — | — |
| Providence St Peter Hospital | $28.70 – $45.92 | — | — |
| Seattle Children's Hospital | — | $42.90 | $42.90 |
| Swedish Edmonds Hospital | $28.70 – $34.44 | — | — |
| Swedish Issaquah | $28.70 – $34.44 | — | — |
| Swedish Medical Center | $28.70 – $34.44 | — | — |
| Swedish Medical Center / Cherry Hill | $28.70 – $34.44 | — | — |
| Tacoma General Allenmore Hospital | $28.13 – $30.94 | $14.40 | $36.00 |
| University of Washington Medical Ctr | $28.70 – $31.57 | $153 | $218 |
| Virginia Mason Medical Center | $19.57 – $29.35 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $28.13 – $31.50 | $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)