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Breast Prosthesis, Mastectomy Form

Maryland rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$158

Typical negotiated rate. In Maryland, July 2026.

Insurers have agreed to pay about $158 for this service. Most negotiated rates run $135 to $158.

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.

How much rates vary

Facilitymedian $182 · 10th to 90th $110 to $309Professionalmedian $158 · 10th to 90th $120 to $214
$50.0$100.0$200.0$500.0$1.0Kfacility $182professional $158

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
Professional
Modifier
Global
Typical Low
$117.49
Median
$158.49
Typical High
$204.17
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$169.82
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$169.82
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$309.03
Typical High
$457.09
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$181.97
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$158.49
Typical High
$239.88
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$263.03

Where Maryland 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.

Maryland $158 · 26th 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.