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New Hampshire rates for HCPCS L8002

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

Facilitymedian $200 · 10th–90th $110–$2340%20%40%10th90th$200Professionalmedian $132 · 10th–90th $85–$1820%20%10th90th$132$100.0$200.0$500.0$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
$109.65 / $109.65 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $109.65 / $162.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $213.80 / $239.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $120.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $123.03 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $134.90 / $169.82
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $245.47