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Arizona rates for HCPCS L8015

External breast prosthesis garment, with mastectomy form, post mastectomy

Facilitymedian $71 · 10th–90th $21–$1550%10%10th90th$71Professionalmedian $38 · 10th–90th $30–$1070%20%10th90th$38$0.1$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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.02 / $141.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $77.62 / $144.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $70.79 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $50.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $46.77
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $50.12 / $338.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $32.36 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $57.54 / $57.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $32.36 / $48.98