HCPCS L0643
Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
Current codeLumbar Sacral Orthosis Brace25 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 | $54.31 – $59.74 | — | — |
| Deaconess Medical Center | $54.31 – $59.74 | — | — |
| Harborview Medical Center | $55.42 – $60.96 | — | — |
| Island Hospital | $171 – $182 | — | — |
| Kadlec Regional Medical Center | $55.42 – $66.50 | — | — |
| Mary Bridge Children's Hospital | $54.31 – $59.74 | — | — |
| MultiCare Auburn Medical Center | $54.31 – $59.74 | — | — |
| MultiCare Covington Medical Center | $54.31 – $59.74 | — | — |
| MultiCare Good Samaritan Hospital | $54.31 – $59.74 | — | — |
| MultiCare Valley Hospital | $55.94 – $59.74 | — | — |
| Olympic Medical Center | $180 – $231 | — | — |
| Overlake Hospital Medical Center & Clinics | $55.42 – $57.64 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $55.42 – $66.50 | — | — |
| Providence Centralia Hospital | $55.42 – $88.67 | — | — |
| Providence Regional Medical Center Everett | $55.42 – $60.96 | — | — |
| Providence St Peter Hospital | $55.42 – $88.67 | — | — |
| Swedish Edmonds Hospital | $55.42 – $66.50 | — | — |
| Swedish Issaquah | $55.42 – $66.50 | — | — |
| Swedish Medical Center | $55.42 – $66.50 | — | — |
| Swedish Medical Center / Cherry Hill | $55.42 – $66.50 | — | — |
| Tacoma General Allenmore Hospital | $54.31 – $59.74 | — | — |
| University of Washington Medical Ctr | $55.42 – $60.96 | — | — |
| Virginia Mason Medical Center | $37.77 – $56.66 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $54.31 – $60.83 | — | — |
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
- $55.42 (fee)