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Breast Prosthesis, Silicone or Equal, No Integral Adhesive

Alaska rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Rates data updated July 2026.

Facilitymedian $229 · 10th–90th $123$4680%20%40%10th90th$229Professionalmedian $288 · 10th–90th $214$6460%10%20%10th90th$288$100.0$200.0$500.0$1.0K$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
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$229.09
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$549.54
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$295.12
Typical High
$446.68
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$478.63
Typical High
$1,148.15
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$457.09
Typical High
$478.63
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$457.09
Typical High
$478.63
Providence
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$467.74
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$281.84
Typical High
$363.08
United
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$239.88
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$234.42
Typical High
$912.01