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Wisconsin rates for HCPCS L8001

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

Facilitymedian $155 · 10th–90th $138$2820%20%40%10th90th$155Professionalmedian $112 · 10th–90th $66$2340%20%10th90th$112$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $75.86 / $125.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $173.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $354.81 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $218.78 / $295.12
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $125.89 / $190.55
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $208.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $151.36 / $707.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $97.72 / $169.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $173.78 / $302.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $234.42 / $426.58
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $309.03 / $707.95
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $144.54 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $109.65 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $75.86 / $125.89