Pavlik harness for infant hip abduction at Dignity Health

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

ORTHO L1620 39X-51

Mt Shasta, CA

See all hospitals reporting HCPCS L1620 →

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Pricing by billing methodology

Price type

How this price compares nationally

Dignity Health’s median price of $167 is 8% below the median hospital's median price ($182), higher than 34% of the 1,005 hospitals reporting HCPCS L1620. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L1620 at Dignity Health

Negotiated rates from the hospital’s own file: 8 payers, 24 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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#
1	Aetna medicare\|all plans fee schedule · outpatient	$46	$46	—	—	—	$46 – $46
2	Anthem medicare\|all plans fee schedule · outpatient	$46	$46	—	—	—	$46 – $46
3	Blue Cross Blue Shield medicare\|all plans fee schedule · outpatient	$46	$46	—	—	—	$46 – $46
4	Humana medicare\|all plans fee schedule · outpatient	$46	$46	—	—	—	$46 – $46
5	Kaiser medicare\|all plans fee schedule · outpatient	$46	$46	—	—	—	$46 – $46
6	UnitedHealthcare medicare\|all plans fee schedule · outpatient	$46	$46	—	—	—	$46 – $46
7	Anthem medicaid\|all plans fee schedule · inpatient	$48	$48	—	—	—	$48 – $48
8	Cigna commercial\|all other plans fee schedule · inpatient	$157	$157	—	—	—	$157 – $157
9	Cigna commercial\|all other plans fee schedule · outpatient	$157	$157	—	—	—	$157 – $157
10	Cigna commercial\|ppo fee schedule · inpatient	$157	$157	—	—	—	$157 – $157
11	Cigna commercial\|ppo fee schedule · outpatient	$157	$157	—	—	—	$157 – $157
12	UnitedHealthcare commercial\|hmo fee schedule · inpatient	$165	$165	—	—	—	$165 – $165
13	UnitedHealthcare commercial\|hmo fee schedule · outpatient	$165	$165	—	—	—	$165 – $165
14	Aetna commercial\|all other plans fee schedule · outpatient	$167	$167	—	—	—	$167 – $167
15	Aetna commercial\|hmo fee schedule · outpatient	$167	$167	—	—	—	$167 – $167
16	Aetna commercial\|ppo fee schedule · outpatient	$167	$167	—	—	—	$167 – $167
17	Aetna commercial\|all other plans fee schedule · inpatient	$169	$169	—	—	—	$169 – $169
18	Aetna commercial\|hmo fee schedule · inpatient	$169	$169	—	—	—	$169 – $169
19	Aetna commercial\|ppo fee schedule · inpatient	$169	$169	—	—	—	$169 – $169
20	UnitedHealthcare commercial\|all other plans fee schedule · inpatient	$169	$169	—	—	—	$169 – $169
21	UnitedHealthcare commercial\|all other plans fee schedule · outpatient	$169	$169	—	—	—	$169 – $169
22	MultiPlan commercial\|all plans fee schedule · inpatient	$188	$188	—	—	—	$188 – $188
23	MultiPlan commercial\|all plans fee schedule · outpatient	$188	$188	—	—	—	$188 – $188
24	Anthem medicaid\|all plans fee schedule · outpatient	$192	$192	—	—	—	$192 – $192

Last updated: Feb 28, 2026

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See Pavlik harness for infant hip abduction pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.