go back

Tennessee rates for HCPCS L8001

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.68 / $65.95 / $65.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.58 / $65.95 / $113.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.71 / $137.02 / $137.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.98 / $98.15 / $98.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.65 / $71.65 / $98.15
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$205.52 / $705.18 / $705.18
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.34 / $762.34 / $1,108.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.63 / $75.95 / $113.70