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Montana rates for HCPCS L8002

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

Facilitymedian $195 · 10th–90th $123–$2450%20%10th90th$195Professionalmedian $126 · 10th–90th $62–$2450%10%10th90th$126$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $117.49 / $173.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $213.80 / $213.80
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $194.98 / $380.19
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $194.98 / $380.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $154.88 / $288.40
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $158.49 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $117.49 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $89.13 / $141.25