go back

Breast Prosthesis, Silicone or Equal, No Integral Adhesive

Arizona rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Rates data updated July 2026.

Facilitymedian $437 · 10th–90th $123$8710%10%10th90th$437Professionalmedian $214 · 10th–90th $170$5010%20%10th90th$214$0.5$2.0$10.0$50.0$200.0$1.0K

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
$602.56
Median
$602.56
Typical High
$602.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$213.80
Typical High
$407.38
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$407.38
Typical High
$467.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$512.86
Typical High
$1,000.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$478.63
Typical High
$954.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$323.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$295.12
Medica
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$316.23
Typical High
$1,995.26
Medica
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$190.55
Typical High
$2,187.76
United
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$371.54
Typical High
$467.74
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$190.55
Typical High
$281.84