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Breast Prosthesis, Mastectomy Form

Missouri rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$182

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $182 for this service. The price depends on where it is billed: about $182 from a physician practice, and about $234 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$182$141 to $214
FacilityA hospital or hospital-owned outpatient department$234$182 to $288

How much rates vary

Facilitymedian $234 · 10th to 90th $132 to $550Professionalmedian $182 · 10th to 90th $126 to $347
$1.0$10.0$100.0$1.0Kfacility $234professional $182

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
$131.83
Median
$194.98
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$194.98
Typical High
$1,096.48
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$1,023.29
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$181.97
Typical High
$269.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$169.82
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$169.82
Medica
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$229.09
Typical High
$645.65
Medica
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$141.25
Typical High
$1,445.44
United
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$234.42
Typical High
$288.40
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$141.25
Typical High
$218.78

Where Missouri 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.

Missouri $182 · 17th 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.