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Breast Prosthesis, Mastectomy Form

Georgia rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$166

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $166 for this service. The price depends on where it is billed: about $166 from a physician practice, and about $282 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 8 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$166$126 to $229
FacilityA hospital or hospital-owned outpatient department$282$170 to $372

How much rates vary

Facilitymedian $282 · 10th to 90th $115 to $1,023Professionalmedian $166 · 10th to 90th $115 to $275
$1.0$10.0$100.0$1.0Kfacility $282professional $166

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
$114.82
Median
$169.82
Typical High
$331.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$134.90
Typical High
$229.09
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$141.25
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$660.69
Typical High
$1,023.29
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$229.09
Typical High
$338.84
CareSource
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
CareSource
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$169.82
Typical High
$380.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$331.13
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$281.84
Typical High
$380.19
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$5,888.44
Typical High
$5,888.44
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$181.97
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$138.04
Typical High
$269.15

Where Georgia 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.

Georgia $166 · 24th 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.