go back

Breast Prosthesis, Mastectomy Form

Alaska rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$195

Typical negotiated rate. In Alaska, July 2026.

Insurers have agreed to pay about $195 for this service. The price depends on where it is billed: about $195 from a physician practice, and about $145 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$195$145 to $240
FacilityA hospital or hospital-owned outpatient department$145$77.62 to $240

How much rates vary

Facilitymedian $145 · 10th to 90th $78 to $257Professionalmedian $195 · 10th to 90th $120 to $339
$100.0$200.0$500.0$1.0Kfacility $145professional $195

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$144.54
Typical High
$213.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$288.40
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$186.21
Typical High
$245.47
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$281.84
Typical High
$812.83
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$251.19
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$239.88
Typical High
$251.19
Providence
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$257.04
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$169.82
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$151.36
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$123.03
Typical High
$575.44

Where Alaska sits

The same service costs 2.8 times more in Kansas than in Nebraska. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Alaska $195 · 16th of 51
KS $339NE $120

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.