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Wisconsin rates for HCPCS L8002

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

Facilitymedian $204 · 10th–90th $182$3720%50%10th90th$204Professionalmedian $148 · 10th–90th $87$3020%10%20%10th90th$148$0.2$1.0$5.0$20.0$100.0$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
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $100.00 / $165.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $338.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $190.55 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $467.74 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $288.40 / $380.19
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $165.96 / $251.19
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $218.78 / $275.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $199.53 / $933.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $125.89 / $223.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $229.09 / $398.11
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $302.00 / $562.34
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $407.38 / $933.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $177.83 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $144.54 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $165.96