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South Carolina rates for HCPCS L8002

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

Facilitymedian $135 · 10th–90th $89–$2510%10%20%10th90th$135Professionalmedian $100 · 10th–90th $83–$1620%10%20%10th90th$100$50.0$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
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $100.00 / $147.91
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $204.17 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $120.23 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $229.09
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $117.49
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $147.91 / $316.23
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $134.90 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $100.00 / $141.25