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Breast Prosthesis, Mastectomy Form

Hawaii rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$269

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $269 for this service. Most negotiated rates run $135 to $269.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $158 · 10th to 90th $107 to $209Professionalmedian $269 · 10th to 90th $105 to $269
$50.0$100.0$200.0$500.0facility $158professional $269

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
$134.90
Typical High
$134.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$169.82
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$245.47
Typical High
$331.13
HMSA
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$269.15
Typical High
$380.19
United
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$151.36
Typical High
$186.21
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$181.97
Typical High
$331.13

Where Hawaii 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.

Hawaii $269 · 4th 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.