go back

Massachusetts rates for HCPCS L8015

External breast prosthesis garment, with mastectomy form, post mastectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $36.31 / $109.65
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $72.44 / $338.84
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $54.95 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $91.20 / $123.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $61.66 / $61.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $46.77 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $50.12
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $61.66 / $93.33
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $72.44 / $338.84
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $54.95 / $72.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $48.98 / $89.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $46.77 / $61.66