go back

Maryland rates for HCPCS L8015

External breast prosthesis garment, with mastectomy form, post mastectomy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $37.15 / $66.07
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $48.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $46.77 / $47.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $46.77
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $72.44 / $107.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $48.98 / $57.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $36.31 / $56.23
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $60.26