HCPCS L0642

Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Current codeLumbar Sacral Orthosis Brace25 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS L0642 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$120 – $1,00516 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$166 – $9589 plans——
Harborview Medical CenterSeattleFile dated 2026-04-01$225 – $2812 plans——
Island HospitalAnacortes$696 – $7834 plans——
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$238 – $7445 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$120 – $1,6897 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$116 – $99417 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$116 – $99417 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$184 – $99412 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$133 – $95610 plans——
Olympic Medical CenterPort AngelesFile dated 2026-06-24$117 – $2096 plans$167$209
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$155 – $1,35710 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$238 – $7649 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$238 – $9335 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$169 – $8847 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$120 – $1,2468 plans——
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$211 – $1,8097 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$211 – $1,0457 plans$654$1,363
Swedish Medical CenterSeattleFile dated 2026-04-01$211 – $1,0459 plans$654$1,363
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$211 – $1,2509 plans$654$1,363
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$116 – $99417 plans——
University of Washington Medical CtrSeattleFile dated 2026-04-01$225 – $4415 plans——
Virginia Mason Medical CenterSeattle$133 – $6367 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$3551 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$120 – $1,20613 plans——

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

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
$141 (fee)