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Tennessee 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
$22.43 / $22.87 / $78.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $22.87 / $39.29
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $50.00 / $52.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.46 / $47.51 / $47.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.42 / $35.00 / $35.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.55 / $25.55 / $35.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.48 / $230.54 / $277.54
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.95 / $322.52 / $331.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.55 / $26.33 / $36.44