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Montana 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
$48.60 / $168.57 / $168.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.00 / $47.42 / $47.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.00 / $47.42 / $47.42
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.43 / $45.16 / $47.42
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.00 / $36.36 / $49.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.76 / $21.86 / $39.29