go back

Arizona rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $831.76 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $229.09 / $933.25
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $323.59 / $501.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $288.40 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $457.09 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $295.12 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $213.80 / $295.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $309.03 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $190.55 / $2,187.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $338.84 / $363.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $190.55 / $281.84