HCPCS L1620 at Prov Sacred HRT Med Ctr & Childs Hosp.

Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Prov Sacred HRT Med Ctr & Childs Hosp., Spokane

Description from CMS's HCPCS Level II code file.

What Prov Sacred HRT Med Ctr & Childs Hosp. publishes for this code: as an outpatient

Prov Sacred HRT Med Ctr & Childs Hosp.’s prices for HCPCS L1620, as an outpatient
Who paysHospital’s fee (lowest – highest)Doctor’s fee the hospital lists
Commercial insuranceInsurer rates$251 – $5389 plans—
Medicare AdvantageInsurer rates$162 – $1957 plans—
Cash pricePaying yourself, without insurance$375—
List priceBefore any discount; few people pay it$535—

Lowest and highest amounts Prov Sacred HRT Med Ctr & Childs Hosp. lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-04-01. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS L1620 at Prov Sacred HRT Med Ctr & Childs Hosp.
BillWhat it’s forOriginal Medicare allowsPrivate plan estimate
Hospital's feeThe hospitalThe service—The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS L1620 at every Washington hospital, with Medicare’s reference amounts.