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Iowa rates for HCPCS L8015

External breast prosthesis garment, with mastectomy form, post mastectomy

Facilitymedian $72 · 10th–90th $48$1860%20%10th90th$72Professionalmedian $41 · 10th–90th $30$850%10%20%10th90th$41$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
$52.48 / $56.23 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.02 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $83.18 / $104.71
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $72.44 / $85.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $93.33 / $338.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $48.98 / $120.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $83.18 / $97.72
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $120.23 / $120.23
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $74.13 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $38.90 / $69.18
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $70.79 / $70.79