HCPCS L5703

Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only

Current codeBelow Knee Orthotic24 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 L5703 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$2,585 – $20,05716 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$3,590 – $12,4859 plans——
Harborview Medical CenterSeattleFile dated 2026-04-01$4,800 – $6,0002 plans$3,675$5,250
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$4,524 – $8,4265 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$2,585 – $22,0167 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$2,513 – $12,96117 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$2,513 – $12,96117 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$2,916 – $12,96112 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$2,872 – $12,45710 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$2,751 – $8,25310 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$4,646 – $9,9529 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$5,070 – $11,2165 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$3,600 – $6,9597 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$2,550 – $9,7948 plans——
Seattle Children's HospitalSeattle$6,750 – $11,99998 plans$12,499$12,499
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$4,500 – $11,0047 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$4,500 – $6,6607 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$4,500 – $10,7149 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$4,500 – $10,7149 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$2,513 – $12,96117 plans——
University of Washington Medical CtrSeattleFile dated 2026-04-01$4,800 – $9,4085 plans——
Virginia Mason Medical CenterSeattle$2,872 – $10,4337 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$7,5701 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$2,585 – $7,78213 plans——

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
$3,000 (fee)