go back

Breast Prosthesis, Mastectomy Form

South Dakota rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$240

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $234 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 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$234$229 to $316
FacilityA hospital or hospital-owned outpatient department$245$200 to $324

How much rates vary

Facilitymedian $245 · 10th to 90th $182 to $468Professionalmedian $234 · 10th to 90th $200 to $398
$100.0$200.0$500.0$1.0Kfacility $245professional $234

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$229.09
Typical High
$245.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$323.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$398.11
Medica
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$263.03
Typical High
$645.65
Medica
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$181.97
Typical High
$1,445.44
Midlands
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$316.23
Typical High
$316.23
Midlands
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Midlands
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$436.52
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$239.88
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$199.53
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$190.55
Typical High
$323.59
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40

Where South Dakota 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 Dakota $240 · 6th 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.