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New Jersey 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
$16.25 / $93.21 / $171.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.25 / $19.57 / $30.96
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.27 / $27.27 / $27.27
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.13 / $29.13 / $29.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.17 / $35.00 / $44.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.55 / $25.55 / $38.72
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.40 / $40.68 / $57.93
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.50 / $29.42 / $29.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.94 / $23.87 / $44.22