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Washington rates for HCPCS L8001

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

Facilitymedian $148 · 10th–90th $95–$3550%20%10th90th$148Professionalmedian $107 · 10th–90th $66–$2140%10%10th90th$107$1.0$5.0$20.0$100.0$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
$95.50 / $95.50 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $81.28 / $131.83
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $144.54 / $144.54
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $165.96
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $190.55 / $416.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $177.83 / $316.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $112.20 / $125.89
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $144.54 / $147.91
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $147.91 / $177.83
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $218.78 / $295.12
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $144.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $218.78 / $218.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $89.13 / $128.82
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $223.87