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Washington rates for HCPCS L8020

Breast prosthesis, mastectomy form

Facilitymedian $288 · 10th–90th $186–$6170%20%10th90th$288Professionalmedian $186 · 10th–90th $115–$3980%10%10th90th$186$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $147.91 / $245.47
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $281.84
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $169.82 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $169.82
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $338.84 / $812.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $338.84 / $562.34
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $223.87 / $245.47
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $281.84 / $288.40
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $288.40 / $288.40
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $426.58 / $575.44
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $281.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $331.13 / $389.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $158.49 / $229.09
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $204.17 / $446.68