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Alaska rates for HCPCS L8000

Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.76 / $62.76 / $62.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.00 / $35.00 / $35.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.55 / $35.00 / $37.31
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.11 / $14.11 / $14.11
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.05 / $68.09 / $107.51
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.13 / $69.98 / $69.98
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.11 / $14.11 / $35.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.55 / $35.00 / $50.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.64 / $35.75 / $68.53