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Breast Prosthesis, Mastectomy Sleeve

Pennsylvania rates for HCPCS L8010

Breast prosthesis, mastectomy sleeve

Rates data updated July 2026.

Facilitymedian $36 · 10th–90th $14$460%10%20%10th90th$36Professionalmedian $32 · 10th–90th $32$440%50%90th$32$0.5$1.0$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$58.88
Typical High
$72.44
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
United
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$23.99
Typical High
$45.71