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Breast Prosthesis, Mastectomy Sleeve

New York rates for HCPCS L8010

Breast prosthesis, mastectomy sleeve

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Sleeve cost?

$38.90

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $38.90 for this service. The price depends on where it is billed: about $46.77 from a physician practice, and about $38.90 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$46.77$38.90 to $50.12
FacilityA hospital or hospital-owned outpatient department$38.90$28.18 to $38.90

How much rates vary

Facilitymedian $39 · 10th to 90th $24 to $39Professionalmedian $47 · 10th to 90th $39 to $51
$0.5$2$10$50facility $39professional $47

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$58.88
Typical High
$72.44
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$50.12
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
United
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$27.54
Typical High
$45.71
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$50.12
Typical High
$64.57
Univera
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$38.90
Typical High
$38.90
Univera
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$50.12

Where New York sits

The same service costs 11.2 times more in Illinois than in Hawaii. 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.

New York· 25th of 51

$38.90

IL $269HI $23.99

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.