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Breast Prosthesis, Mastectomy Form

Iowa rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$214

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $214 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $251 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$204$135 to $240
FacilityA hospital or hospital-owned outpatient department$251$182 to $389

How much rates vary

Facilitymedian $251 · 10th to 90th $158 to $1,259Professionalmedian $204 · 10th to 90th $117 to $316
$1.0$10.0$100.0$1.0Kfacility $251professional $204

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
$134.90
Median
$223.87
Typical High
$229.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$181.97
Typical High
$245.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$169.82
Typical High
$323.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$316.23
Typical High
$398.11
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$263.03
Typical High
$288.40
Medica
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$371.54
Typical High
$1,258.93
Medica
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$181.97
Typical High
$457.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$331.13
Typical High
$371.54
Midlands
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Midlands
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$478.63
Typical High
$478.63
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,621.81
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$524.81
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$158.49
Typical High
$275.42
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$288.40
Typical High
$288.40

Where Iowa 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.

Iowa $214 · 10th 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.