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Mississippi rates for HCPCS L8015

External Breast Prosthesis Garment With Mastectomy Form Post Mastectomy (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.77 / $40.77 / $63.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.49 / $41.41 / $63.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.38 / $56.38 / $56.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.38 / $56.38 / $56.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.82 / $46.82 / $47.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.18 / $34.18 / $47.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.55 / $36.29 / $57.41