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Breast Prosthesis, Mastectomy Form

Virginia 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 Virginia, July 2026.

Insurers have agreed to pay about $182 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $309 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 8 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$158$151 to $204
FacilityA hospital or hospital-owned outpatient department$309$200 to $309

How much rates vary

Facilitymedian $309 · 10th to 90th $158 to $380Professionalmedian $158 · 10th to 90th $126 to $302
$1.0$10.0$100.0$1.0K$10.0Kfacility $309professional $158

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
$158.49
Median
$158.49
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$158.49
Typical High
$158.49
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$323.59
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$380.19
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$169.82
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$169.82
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$309.03
Typical High
$426.58
Medcost
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$199.53
Typical High
$302.00
Medcost
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$199.53
Typical High
$354.81
Medcost
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$169.82
Typical High
$199.53
Sentara
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$251.19
Typical High
$891.25
Sentara
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$251.19
Typical High
$891.25
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$181.97
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$151.36
Typical High
$229.09

Where Virginia 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.

Virginia $182 · 19th 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.