HCPCS L5684
Addition to lower extremity, below knee, fork strap
Current codeBelow Knee Orthotic24 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 | $67.70 – $525 | — | — |
| Deaconess Medical Center | $94.02 – $327 | — | — |
| Harborview Medical Center | $126 – $157 | $96.25 | $138 |
| Kadlec Regional Medical Center | $118 – $221 | — | — |
| Mary Bridge Children's Hospital | $67.70 – $577 | — | — |
| MultiCare Auburn Medical Center | $65.82 – $339 | — | — |
| MultiCare Covington Medical Center | $65.82 – $339 | — | — |
| MultiCare Good Samaritan Hospital | $76.37 – $339 | — | — |
| MultiCare Valley Hospital | $75.22 – $326 | — | — |
| Overlake Hospital Medical Center & Clinics | $72.05 – $216 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $122 – $261 | — | — |
| Providence Centralia Hospital | $133 – $294 | — | — |
| Providence Regional Medical Center Everett | $94.28 – $182 | — | — |
| Providence St Peter Hospital | $66.78 – $257 | — | — |
| Seattle Children's Hospital | $131 – $233 | $243 | $243 |
| Swedish Edmonds Hospital | $118 – $288 | — | — |
| Swedish Issaquah | $118 – $174 | $121 | $252 |
| Swedish Medical Center | $118 – $281 | $121 | $252 |
| Swedish Medical Center / Cherry Hill | $118 – $281 | $121 | $252 |
| Tacoma General Allenmore Hospital | $65.82 – $339 | — | — |
| University of Washington Medical Ctr | $126 – $246 | $130 | $185 |
| Virginia Mason Medical Center | $75.22 – $273 | — | — |
| Wellfound Behavioral Health Hospital | $198 | — | — |
| Yakima Valley Memorial | $67.70 – $204 | — | — |
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
- $78.57 (fee)