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
$40.43 / $40.43 / $40.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.74 / $40.43 / $40.43
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.19 / $58.19 / $58.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.80 / $83.12 / $92.35
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.64 / $70.64 / $72.73
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.64 / $70.64 / $70.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.82 / $46.82 / $58.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.18 / $46.82 / $56.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.55 / $36.29 / $48.71