HCPCS L1990
Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated
Current codeBelow Knee Orthotic26 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $562 – $4,358 | — | — |
| Deaconess Medical Center | $780 – $2,712 | — | — |
| Harborview Medical Center | $1,043 – $1,304 | $786 – $798 | $1,123 – $1,141 |
| Kadlec Regional Medical Center | $983 – $1,831 | — | — |
| Mary Bridge Children's Hospital | $562 – $4,783 | — | — |
| MultiCare Auburn Medical Center | $546 – $2,816 | — | — |
| MultiCare Covington Medical Center | $546 – $2,816 | — | — |
| MultiCare Good Samaritan Hospital | $634 – $2,816 | — | — |
| MultiCare Valley Hospital | $624 – $2,706 | — | — |
| Overlake Hospital Medical Center & Clinics | $598 – $1,793 | — | — |
| PeaceHealth Southwest Medical Cente | $261 – $2,115 | $753 | $1,158 |
| PeaceHealth St John Medical Center | $261 – $820 | $664 | $1,021 |
| PeaceHealth St Joseph Medical Center | $654 – $820 | $720 | $1,107 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1,009 – $2,162 | — | — |
| Providence Centralia Hospital | $1,101 – $2,437 | — | — |
| Providence Regional Medical Center Everett | $782 – $1,512 | — | — |
| Providence St Peter Hospital | $554 – $2,128 | — | — |
| Swedish Edmonds Hospital | $978 – $2,391 | $809 | $1,685 |
| Swedish Issaquah | $978 – $1,447 | $809 | $1,685 |
| Swedish Medical Center | $978 – $2,328 | $931 | $1,940 |
| Swedish Medical Center / Cherry Hill | $978 – $2,328 | $945 | $1,969 |
| Tacoma General Allenmore Hospital | $546 – $2,816 | — | — |
| University of Washington Medical Ctr | $1,043 – $2,044 | $1,108 | $1,582 |
| Virginia Mason Medical Center | $624 – $2,267 | — | — |
| Wellfound Behavioral Health Hospital | $1,645 | — | — |
| Yakima Valley Memorial | $562 – $1,691 | — | — |
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
- $652 (fee)