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Pennsylvania rates for HCPCS L8001

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

Facilitymedian $182 · 10th–90th $66–$2570%20%10th90th$182Professionalmedian $74 · 10th–90th $65–$1320%50%10th90th$74$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$66.07 / $257.04 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $72.44 / $125.89
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
$147.91 / $147.91 / $147.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $97.72
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $199.53 / $288.40
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $104.71 / $151.36
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $109.65
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $75.86 / $125.89
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $208.93 / $288.40
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $141.25 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $181.97 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $81.28 / $151.36