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Breast Prosthesis, Mastectomy Form

South Carolina 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 South Carolina, 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 $182 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$145$123 to $204
FacilityA hospital or hospital-owned outpatient department$182$123 to $251

How much rates vary

Facilitymedian $182 · 10th to 90th $123 to $339Professionalmedian $145 · 10th to 90th $115 to $204
$100.0$200.0$500.0$1.0Kfacility $182professional $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
$123.03
Median
$123.03
Typical High
$123.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$125.89
Typical High
$204.17
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$263.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$251.19
Typical High
$281.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$263.03
Typical High
$346.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$169.82
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$316.23
Medcost
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$181.97
Medcost
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$213.80
Typical High
$426.58
Medcost
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
Molina
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$181.97
Typical High
$331.13
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$138.04
Typical High
$199.53

Where South 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.

South Carolina $145 · 38th 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.