go back

Alaska rates for HCPCS L8020

Breast prosthesis, mastectomy form

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.64 / $215.64 / $215.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.64 / $170.64 / $170.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.57 / $170.64 / $181.91
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.55 / $77.55 / $77.55
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.94 / $274.70 / $369.38
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.42 / $187.42 / $187.42
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.55 / $77.55 / $170.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.57 / $181.91 / $275.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.78 / $122.86 / $235.47