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Minnesota rates for HCPCS L8015

External breast prosthesis garment, with mastectomy form, post mastectomy

Facilitymedian $85 · 10th–90th $60–$5250%20%10th90th$85Professionalmedian $72 · 10th–90th $35–$830%50%10th90th$72$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
$60.26 / $60.26 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $43.65 / $60.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $72.44 / $93.33
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $72.44 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $269.15 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $95.50 / $107.15
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $269.15 / $524.81
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $114.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $72.44 / $338.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $34.67 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.52 / $42.66 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $38.02 / $100.00