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Breast Prosthesis, Mastectomy Form

Tennessee rates for HCPCS L8020

Breast prosthesis, mastectomy form

Rates data updated July 2026.

How much does Breast Prosthesis, Mastectomy Form cost?

$129

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $129 for this service. The price depends on where it is billed: about $129 from a physician practice, and about $209 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$129$117 to $182
FacilityA hospital or hospital-owned outpatient department$209$158 to $1,288

How much rates vary

Facilitymedian $209 · 10th to 90th $117 to $1,288Professionalmedian $129 · 10th to 90th $115 to $229
$1.0$10.0$100.0$1.0Kfacility $209professional $129

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
$117.49
Median
$117.49
Typical High
$208.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$120.23
Typical High
$229.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$218.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$165.96
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,288.25
Typical High
$1,288.25
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$2,137.96
Typical High
$2,137.96
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$134.90
Typical High
$190.55

Where Tennessee 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.

Tennessee $129 · 48th 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.