go back

Maine rates for HCPCS L8002

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $100.00 / $302.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $229.09 / $263.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $120.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $204.17
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $123.03 / $302.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $117.49 / $117.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $134.90 / $186.21