go back

Missouri rates for HCPCS L8000

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.42 / $36.47 / $38.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.18 / $25.42 / $40.65
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.40 / $36.40 / $58.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.55 / $50.98 / $224.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.28 / $32.40 / $39.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.97 / $35.00 / $35.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.55 / $25.55 / $37.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.57 / $39.29 / $230.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.22 / $25.95 / $47.41
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.42 / $41.42 / $41.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.22 / $24.22 / $35.10