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Breast Prosthesis, Mastectomy Form

New Hampshire 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 New Hampshire, 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 $245 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 6 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$158 to $209
FacilityA hospital or hospital-owned outpatient department$245$162 to $263

How much rates vary

Facilitymedian $245 · 10th to 90th $135 to $302Professionalmedian $182 · 10th to 90th $126 to $209
$100.0$200.0$500.0$1.0Kfacility $245professional $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
$134.90
Median
$134.90
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$134.90
Typical High
$162.18
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$263.03
Typical High
$302.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
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
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$158.49
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$181.97
Typical High
$208.93
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$302.00

Where New Hampshire 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.

New Hampshire $182 · 18th 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.