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Breast Prosthesis, Mastectomy Form

Connecticut rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$129

Typical negotiated rate. In Connecticut, July 2026.

Insurers have agreed to pay about $129 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $182 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$126$117 to $182
FacilityA hospital or hospital-owned outpatient department$182$155 to $245

How much rates vary

Facilitymedian $182 · 10th to 90th $112 to $263Professionalmedian $126 · 10th to 90th $105 to $251
$100.0$200.0$500.0$1.0Kfacility $182professional $126

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$120.23
Typical High
$251.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$245.47
Typical High
$295.12
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$181.97
Typical High
$354.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$169.82
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$190.55
Typical High
$323.59
Health New England
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$158.49
Typical High
$213.80
United
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$128.82
Typical High
$213.80

Where Connecticut 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.

Connecticut $129 · 49th 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.