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New Hampshire rates for HCPCS L8001

Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type

Facilitymedian $151 · 10th–90th $83–$1780%10%20%10th90th$151Professionalmedian $102 · 10th–90th $66–$1380%20%10th90th$102$50.0$100.0$200.0$500.0

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
$83.18 / $83.18 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $83.18 / $123.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $162.18 / $181.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $97.72
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $93.33 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $102.33 / $128.82
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $186.21