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Wisconsin rates for HCPCS L8010

Breast prosthesis, mastectomy sleeve

Facilitymedian $93 · 10th–90th $24–$1740%10%10th90th$93Professionalmedian $58 · 10th–90th $18–$1950%20%10th90th$58$0.5$2.0$10.0$50.0$200.0

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

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $109.65 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $57.54 / $72.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $64.57 / $75.86
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $181.97
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $204.17 / $204.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $28.18 / $45.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $16.98 / $30.90