go back

Illinois rates for HCPCS L8002

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $102.33 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $204.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $389.05 / $1,778.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $199.53 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $218.78
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $199.53 / $245.47
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $257.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $120.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $158.49 / $288.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $100.00 / $158.49