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North Dakota rates for HCPCS L8015

External breast prosthesis garment, with mastectomy form, post mastectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $38.02 / $60.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $81.28 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $104.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $61.66 / $338.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $36.31 / $72.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $104.71 / $104.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $36.31 / $77.62