go back

Connecticut rates for HCPCS L8015

External breast prosthesis garment, with mastectomy form, post mastectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $34.67 / $109.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $72.44 / $87.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $44.67 / $47.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $46.77 / $47.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $51.29 / $70.79
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $26.92 / $42.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $35.48 / $57.54