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Utah rates for HCPCS L8001

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

Facilitymedian $89 · 10th–90th $43–$1510%20%40%10th90th$89Professionalmedian $110 · 10th–90th $43–$6460%10%10th90th$110$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $81.28 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $97.72
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $112.20 / $144.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $151.36 / $151.36
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $109.65 / $165.96
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $151.36 / $154.88
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $154.88 / $181.97
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $77.62 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $67.61 / $112.20