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Breast Prosthesis, Mastectomy Sleeve

Nationwide rates for HCPCS L8010

Breast prosthesis, mastectomy sleeve

Rates data updated October 2026.

How much does Breast Prosthesis, Mastectomy Sleeve cost?

$50.12

Typical negotiated rate. Nationwide, October 2026.

Insurers have agreed to pay about $50.12 for this service. The price depends on where it is billed: about $50.12 from a physician practice, and about $38.90 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 34 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$50.12$39.81 to $182
FacilityA hospital or hospital-owned outpatient department$38.90$34.67 to $56.23

How much rates vary

Facilitymedian $39 · 10th to 90th $30 to $148Professionalmedian $50 · 10th to 90th $31 to $204
$20$50$100$200$500$1Kfacility $39professional $50

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$23.99
Median
$23.99
Typical High
$26.92
AllWays Health Partners
Setting
Professional
Modifier
None (both parts)
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Asuris Northwest Health
Setting
Facility
Modifier
None
Typical Low
$19.95
Median
$23.99
Typical High
$54.95
Asuris Northwest Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$181.97
Median
$181.97
Typical High
$204.17
Aultcare
Setting
Professional
Modifier
None (both parts)
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
AvMed
Setting
Professional
Modifier
None (both parts)
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$457.09
Typical High
$3,019.95
BCBS Minnesota
Setting
Facility
Modifier
None
Typical Low
$47.86
Median
$199.53
Typical High
$363.08
BCBS Mississippi
Setting
Facility
Modifier
None
Typical Low
$74.13
Median
$74.13
Typical High
$81.28
BCBS Mississippi
Setting
Professional
Modifier
None (both parts)
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
BCBS North Carolina
Setting
Professional
Modifier
None (both parts)
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Cigna
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$162.18
Typical High
$426.58
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$57.54
Median
$58.88
Typical High
$74.13
Excellus BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$38.90
Median
$38.90
Typical High
$50.12
Geisinger
Setting
Professional
Modifier
None (both parts)
Typical Low
$32.36
Median
$32.36
Typical High
$38.02
Health Partners
Setting
Facility
Modifier
None
Typical Low
$109.65
Median
$173.78
Typical High
$407.38
Health Partners
Setting
Professional
Modifier
None (both parts)
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Horizon BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$28.84
Median
$28.84
Typical High
$60.26
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$53.70
Median
$75.86
Typical High
$154.88
Lucent Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$181.97
Median
$204.17
Typical High
$204.17
MVP Health Care
Setting
Professional
Modifier
None (both parts)
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$23.99
Median
$23.99
Typical High
$26.92
Mass General Brigham
Setting
Professional
Modifier
None (both parts)
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Medcost
Setting
Facility
Modifier
None
Typical Low
$41.69
Median
$41.69
Typical High
$41.69
Medcost
Setting
Professional
Modifier
None (both parts)
Typical Low
$26.92
Median
$41.69
Typical High
$54.95
Medica
Setting
Facility
Modifier
None
Typical Low
$33.88
Median
$147.91
Typical High
$147.91
Medica
Setting
Professional
Modifier
None (both parts)
Typical Low
$30.20
Median
$194.98
Typical High
$194.98
Midlands
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$44.67
Typical High
$44.67
Midlands
Setting
Professional
Modifier
None (both parts)
Typical Low
$45.71
Median
$56.23
Typical High
$67.61
Molina
Setting
Professional
Modifier
None (both parts)
Typical Low
$60.26
Median
$74.13
Typical High
$75.86
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$28.18
Median
$28.18
Typical High
$40.74
Optum
Setting
Professional
Modifier
None (both parts)
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Oscar Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$32.36
Median
$66.07
Typical High
$66.07
Pacific Source
Setting
Facility
Modifier
None
Typical Low
$45.71
Median
$56.23
Typical High
$56.23
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$2,089.30
Typical High
$2,290.87
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None (both parts)
Typical Low
$6.03
Median
$25.12
Typical High
$245.47
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$38.02
Median
$38.02
Typical High
$38.02
Premera BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$38.02
Median
$38.02
Typical High
$112.20
Priority Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Quartz
Setting
Professional
Modifier
None
Typical Low
$27.54
Median
$75.86
Typical High
$89.13
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
UPMC Health Plan
Setting
Professional
Modifier
None (both parts)
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
United
Setting
Facility
Modifier
None
Typical Low
$30.20
Median
$36.31
Typical High
$38.90
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$17.78
Median
$27.54
Typical High
$57.54
Univera
Setting
Facility
Modifier
None
Typical Low
$35.48
Median
$38.90
Typical High
$38.90
Univera
Setting
Professional
Modifier
None (both parts)
Typical Low
$38.90
Median
$38.90
Typical High
$50.12
University Health Alliance
Setting
Professional
Modifier
None (both parts)
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
13 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Capital Blue Cross
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Medcost
Setting
Professional
Modifier
26 · Professional part
Typical Low
$10.72
Median
$12.88
Typical High
$22.39
Medcost
Setting
Professional
Modifier
50 · Both sides
Typical Low
$39.81
Median
$63.10
Typical High
$95.50
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$13.49
Median
$20.89
Typical High
$31.62
Medcost
Setting
Professional
Modifier
80 · Assistant surgeon
Typical Low
$5.37
Median
$8.32
Typical High
$12.88
Medcost
Setting
Professional
Modifier
81 · Minimal assistant surgeon
Typical Low
$3.72
Median
$5.89
Typical High
$8.91
Medcost
Setting
Professional
Modifier
82 · Assistant surgeon, no resident
Typical Low
$3.72
Median
$5.89
Typical High
$8.91
Medcost
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$3.72
Median
$5.89
Typical High
$8.91
Medcost
Setting
Professional
Modifier
SH · Second concurrent infusion
Typical Low
$20.89
Median
$20.89
Typical High
$20.89
Medcost
Setting
Professional
Modifier
SJ · Third+ concurrent infusion
Typical Low
$20.89
Median
$20.89
Typical High
$20.89
Medcost
Setting
Professional
Modifier
TC · Technical part
Typical Low
$15.85
Median
$19.05
Typical High
$33.11
Premera BCBS
Setting
Facility
Modifier
NR · New when rented
Typical Low
$38.02
Median
$38.02
Typical High
$38.02
Premera BCBS
Setting
Professional
Modifier
NR · New when rented
Typical Low
$38.02
Median
$38.02
Typical High
$112.20

What it costs in each state

The same service costs 9.5 times more in Illinois than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Touch or drag across the chart to see any state's rate.

IL $269MT $28.18

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.