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Breast Prosthesis, Mastectomy Form

Illinois rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$209

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $195 from a physician practice, and about $275 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 7 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$195$135 to $275
FacilityA hospital or hospital-owned outpatient department$275$135 to $468

How much rates vary

Facilitymedian $275 · 10th to 90th $135 to $1,698Professionalmedian $195 · 10th to 90th $126 to $275
$1.0$10.0$100.0$1.0Kfacility $275professional $195

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
$134.90
Typical High
$275.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$134.90
Typical High
$275.42
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
BCBS
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$512.86
Typical High
$2,454.71
BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$169.82
Typical High
$323.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$275.42
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$269.15
Typical High
$331.13
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$223.87
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$134.90
Typical High
$229.09

Where Illinois 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.

Illinois $209 · 12th 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.