go back

Arkansas rates for HCPCS L8015

External breast prosthesis garment, with mastectomy form, post mastectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $38.90 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $54.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $46.77 / $58.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $33.88 / $46.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $74.13 / $89.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $34.67 / $51.29