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Breast Prosthesis, Mastectomy Sleeve

Utah rates for HCPCS L8010

Breast prosthesis, mastectomy sleeve

Rates data updated July 2026.

Facilitymedian $24 · 10th–90th $15$390%20%10th90th$24Professionalmedian $68 · 10th–90th $30$760%20%40%10th90th$68$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
$57.54
Typical High
$72.44
Molina
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$74.13
Typical High
$75.86
United
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$23.99
Typical High
$38.90
United
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$36.31