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Every billing code / Equipment and supplies / Orthotic Devices

HCPCS L1902

Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf

Current codeBelow Knee Orthotic29 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.

HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$54.02 – $75219 plans$29.60 – $69.20$74.00 – $173
Deaconess Medical CenterSpokaneFile dated 2026-08-27$27.49 – $46816 plans$29.60 – $69.20$74.00 – $173
Harborview Medical CenterSeattleFile dated 2026-04-01$180 – $2252 plans$96.98 – $98.42$139 – $141
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$170 – $3165 plans$57.18$81.68
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$47.80 – $82618 plans$29.60 – $69.20$74.00 – $173
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$54.02 – $48620 plans$29.60 – $69.20$74.00 – $173
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$54.02 – $48620 plans$29.60 – $69.20$74.00 – $173
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$54.02 – $48620 plans$29.60 – $69.20$74.00 – $173
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$27.49 – $46716 plans$29.60 – $69.20$74.00 – $173
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$103 – $30910 plans——
PeaceHealth St Joseph Medical CenterBellingham$117 – $1472 plans$131$201
PeaceHealth United General Medical CenterSedro Woolley—$114$175
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$174 – $3739 plans$74.19 – $336$106 – $480
Providence Centralia HospitalCentraliaFile dated 2026-04-01$190 – $4215 plans$43.68 – $72.30$84.00 – $139
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$74.19 – $123$106 – $175
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$69.83 – $116$99.75 – $165
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$135 – $2617 plans$46.41 – $76.82$89.25 – $148
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$69.83 – $116$99.75 – $165
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$44.10 – $73.00$63.00 – $104
Providence St Peter HospitalOlympiaFile dated 2026-04-01$95.61 – $3678 plans$43.68 – $72.30$84.00 – $139
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$169 – $4137 plans$20.57 – $143$42.86 – $297
Swedish IssaquahIssaquahFile dated 2026-04-01$169 – $2507 plans$20.57 – $149$42.86 – $311
Swedish Medical CenterSeattleFile dated 2026-04-01$169 – $4029 plans$20.57 – $149$42.86 – $311
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$169 – $4029 plans$20.57 – $149$42.86 – $311
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$54.02 – $48620 plans$29.60 – $69.20$74.00 – $173
University of Washington Medical CtrSeattleFile dated 2026-04-01$180 – $3535 plans$174 – $178$249 – $255
Virginia Mason Medical CenterSeattle$108 – $3917 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$2841 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$22.05 – $29219 plans$18.00 – $40.00$45.00 – $100

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
$112 (fee)