go back

Breast Prosthesis, Mastectomy Form

Arizona rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$145

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $145 for this service. The price depends on where it is billed: about $132 from a physician practice, and about $204 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$132$117 to $182
FacilityA hospital or hospital-owned outpatient department$204$123 to $324

How much rates vary

Facilitymedian $204 · 10th to 90th $78 to $490Professionalmedian $132 · 10th to 90th $112 to $269
$100$200$500$1Kfacility $204professional $132

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
Facility
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$134.90
Typical High
$269.15
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
BCBS
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$281.84
Typical High
$549.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$263.03
Typical High
$524.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$169.82
Medica
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$186.21
Typical High
$1,258.93
Medica
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$120.23
Typical High
$1,445.44
United
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$204.17
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$120.23
Typical High
$181.97

Where Arizona sits

The same service costs 2.8 times more in Kansas than in Nebraska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Arizona· 35th of 51

$145

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.