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Pennsylvania rates for HCPCS L8000

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

Facilitymedian $76 · 10th–90th $30–$2630%10%20%10th90th$76Professionalmedian $25 · 10th–90th $19–$520%20%40%10th90th$25$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $75.86 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.44 / $77.62
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $38.02
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $758.58 / $1,000.00
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $33.11 / $33.11
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $43.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $34.67 / $44.67
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $34.67
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $58.88 / $85.11
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $31.62 / $44.67
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $154.88 / $269.15
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $30.90 / $33.11
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $380.19 / $1,000.00
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $33.11
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $20.89 / $38.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.99 / $40.74
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $63.10 / $87.10
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $31.62 / $41.69
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $31.62 / $158.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $60.26 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.12 / $44.67