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Missouri rates for HCPCS L8015

External breast prosthesis garment, with mastectomy form, post mastectomy

Facilitymedian $59 · 10th–90th $35–$1480%20%10th90th$59Professionalmedian $42 · 10th–90th $31–$850%20%10th90th$42$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
$32.36 / $47.86 / $47.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.02 / $104.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $44.67 / $67.61
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $48.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $46.77
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $57.54 / $162.18
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $36.31 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $58.88 / $58.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $35.48 / $54.95