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Breast Prosthesis, Mastectomy Form

North Carolina rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$204

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $204 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $219 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$204$158 to $209
FacilityA hospital or hospital-owned outpatient department$219$170 to $282

How much rates vary

Facilitymedian $219 · 10th to 90th $123 to $468Professionalmedian $204 · 10th to 90th $123 to $224
$1.0$10.0$100.0$1.0K$10.0Kfacility $219professional $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
$204.17
Median
$204.17
Typical High
$204.17
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$204.17
Typical High
$204.17
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$208.93
Typical High
$263.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$269.15
Typical High
$549.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$223.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$169.82
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$204.17
Medcost
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$138.04
Typical High
$199.53
Medcost
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$223.87
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$213.80
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$138.04
Typical High
$208.93
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,288.25
Typical High
$1,288.25
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$2,137.96

Where North Carolina 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.

North Carolina $204 · 15th 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.