HCPCS L5694
Addition to lower extremity, above knee, pelvic control belt, padded and lined
Current code24 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 | $254 – $1,972 | — | — |
| Deaconess Medical Center | $353 – $1,228 | — | — |
| Harborview Medical Center | $472 – $590 | $361 | $516 |
| Kadlec Regional Medical Center | $445 – $829 | — | — |
| Mary Bridge Children's Hospital | $254 – $2,165 | — | — |
| MultiCare Auburn Medical Center | $247 – $1,274 | — | — |
| MultiCare Covington Medical Center | $247 – $1,274 | — | — |
| MultiCare Good Samaritan Hospital | $287 – $1,274 | — | — |
| MultiCare Valley Hospital | $282 – $1,225 | — | — |
| Overlake Hospital Medical Center & Clinics | $271 – $812 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $457 – $979 | — | — |
| Providence Centralia Hospital | $499 – $1,103 | — | — |
| Providence Regional Medical Center Everett | $354 – $684 | — | — |
| Providence St Peter Hospital | $251 – $963 | — | — |
| Seattle Children's Hospital | $445 – $791 | $824 | $824 |
| Swedish Edmonds Hospital | $442 – $1,082 | — | — |
| Swedish Issaquah | $442 – $655 | — | — |
| Swedish Medical Center | $442 – $1,054 | — | — |
| Swedish Medical Center / Cherry Hill | $442 – $1,054 | — | — |
| Tacoma General Allenmore Hospital | $247 – $1,274 | — | — |
| University of Washington Medical Ctr | $472 – $925 | $506 | $723 |
| Virginia Mason Medical Center | $282 – $1,026 | — | — |
| Wellfound Behavioral Health Hospital | $744 | — | — |
| Yakima Valley Memorial | $254 – $765 | — | — |
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
- $295 (fee)