Flexible pelvic and sacral support brace, prefabricated at MedStar Georgetown Hospital

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

BRACE LUMBAR FLEX PLVC SCRL SP

Washington, DC

See all payers reporting HCPCS L0621 →

Payers reporting HCPCS L0621 at MedStar Georgetown Hospital

Negotiated rates from the hospital’s own file: 8 payers, 16 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	Carefirst carefirst medicare advantage facility · fee schedule · outpatient	$67	$67	—	—	—	$67 – $67
2	Tricare tricare facility · fee schedule · outpatient	$67	$67	—	—	—	$67 – $67
3	UnitedHealthcare optum va community care facility · fee schedule · outpatient	$67	$67	—	—	—	$67 – $67
4	UnitedHealthcare united secure facility · fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
5	Aetna aetna medicare facility · fee schedule · outpatient	$69	$69	—	—	—	$69 – $69
6	Humana humana medicare advantage facility · fee schedule · outpatient	$70	$70	—	—	—	$70 – $70
7	UnitedHealthcare unitedhealthcare community plan of maryland facility · percent of total billed charges · outpatientfrom % of charges	$76	$76	—	—	—	$76 – $76
8	Carefirst all carefirst hmo plans facility · percent of total billed charges · outpatientfrom % of charges	$92	$92	—	—	—	$92 – $92
9	Carefirst all carefirst ppo plans facility · percent of total billed charges · outpatientfrom % of charges	$92	$92	—	—	—	$92 – $92
10	UnitedHealthcare unitedhealthcare community plan of maryland facility · percent of total billed charges · inpatientfrom % of charges	$94	$94	—	—	—	$94 – $94
11	Cigna all cigna hmo facility · percent of total billed charges · outpatientfrom % of charges	$174	$174	—	—	—	$174 – $174
12	Cigna all cigna ppo facility · percent of total billed charges · outpatientfrom % of charges	$174	$174	—	—	—	$174 – $174
13	Phcs private healthcare systems (phcs) facility · percent of total billed charges · inpatientfrom % of charges	$216	$216	—	—	—	$216 – $216
14	Phcs private healthcare systems (phcs) facility · percent of total billed charges · outpatientfrom % of charges	$216	$216	—	—	—	$216 – $216
15	First Health first health facility · percent of total billed charges · inpatientfrom % of charges	$229	$229	—	—	—	$229 – $229
16	First Health first health facility · percent of total billed charges · outpatientfrom % of charges	$229	$229	—	—	—	$229 – $229