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Breast Prosthesis, Mastectomy Form

New Jersey rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$145

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $145 for this service. The price depends on where it is billed: about $145 from a physician practice, and about $107 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 5 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$145$126 to $191
FacilityA hospital or hospital-owned outpatient department$107$105 to $204

How much rates vary

Facilitymedian $107 · 10th to 90th $105 to $295Professionalmedian $145 · 10th to 90th $107 to $209
$100$200$500$1Kfacility $107professional $145

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
$104.71
Median
$104.71
Typical High
$104.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$134.90
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$169.82
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$169.82
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$389.05
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$223.87
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$173.78
Typical High
$288.40

Where New Jersey sits

The same service costs 2.8 times more in Kansas than in Nebraska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 36th of 51

$145

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.