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Montana rates for HCPCS L8015

External breast prosthesis garment, with mastectomy form, post mastectomy

Facilitymedian $71 · 10th–90th $47–$890%20%40%10th90th$71Professionalmedian $49 · 10th–90th $22–$1070%10%10th90th$49$20.0$50.0$100.0$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
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $43.65 / $107.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $77.62 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $77.62 / $77.62
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $70.79 / $138.04
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $70.79 / $138.04
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $67.61 / $104.71
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $77.62 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $40.74 / $42.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $32.36 / $51.29