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Breast Prosthesis, Silicone or Equal, No Integral Adhesive

Nationwide rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Rates data updated July 2026.

Facilitymedian $355 · 10th–90th $214$1,0000%20%10th90th$355Professionalmedian $245 · 10th–90th $170$4470%20%40%10th90th$245$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$309.03
Typical High
$676.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$208.93
Typical High
$354.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$295.12
Typical High
$891.25
BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$295.12
Typical High
$512.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$323.59
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$213.80
Typical High
$416.87