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Breast Prosthesis, Mastectomy Sleeve

Indiana rates for HCPCS L8010

Breast prosthesis, mastectomy sleeve

Rates data updated October 2026.

How much does Breast Prosthesis, Mastectomy Sleeve cost?

$38.90

Typical facility fee. In Indiana, October 2026.

Insurers have agreed to pay about $38.90 for this service. Most negotiated rates run $30.20 to $245.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $39 · 10th to 90th $30 to $2,188Professionalmedian $30 · 10th to 90th $12 to $72
$10$50$200$1Kfacility $39professional $30

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

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.02
Median
$47.86
Typical High
$72.44
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
Typical Low
$6.03
Median
$25.12
Typical High
$245.47
United
Setting
Facility
Modifier
None
Typical Low
$30.20
Median
$36.31
Typical High
$38.90

Where Indiana sits

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.

Indiana· 31st of 48

$38.90

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.