HCPCS L1620

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

Current code25 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 L1620 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$140 – $1,08519 plans$82.80 – $178$207 – $445
Deaconess Medical CenterSpokaneFile dated 2026-08-27$76.90 – $67516 plans$82.80 – $178$207 – $445
Harborview Medical CenterSeattleFile dated 2026-04-01$260 – $3242 plans$194 – $199$277 – $284
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$245 – $4565 plans——
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01—$48.75 – $107$75.00 – $164
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$134 – $1,19018 plans$82.80 – $178$207 – $445
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$136 – $70120 plans$82.80 – $178$207 – $445
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$136 – $70120 plans$82.80 – $178$207 – $445
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$136 – $70120 plans$82.80 – $178$207 – $445
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$76.90 – $67416 plans$82.80 – $178$207 – $445
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$149 – $44610 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$251 – $5389 plans$375$535
Providence Centralia HospitalCentraliaFile dated 2026-04-01$274 – $6075 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$195 – $3767 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$138 – $5308 plans——
Seattle Children's HospitalSeattle$382 – $67998 plans$708$708
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$243 – $5957 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$243 – $3607 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$243 – $5799 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$243 – $5799 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$136 – $70120 plans$82.80 – $178$207 – $445
University of Washington Medical CtrSeattleFile dated 2026-04-01$260 – $5095 plans$274 – $280$392 – $401
Virginia Mason Medical CenterSeattle$155 – $5647 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$4091 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$101 – $42119 plans$82.80 – $112$207 – $279

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
$162 (fee)