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Breast Prosthesis, Silicone or Equal, No Integral Adhesive

Maryland rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Rates data updated July 2026.

Facilitymedian $295 · 10th–90th $186$3980%20%10th90th$295Professionalmedian $209 · 10th–90th $170$3020%20%40%10th90th$209$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
$169.82
Median
$208.93
Typical High
$295.12
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$234.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$295.12
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$295.12
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$398.11
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$281.84
Typical High
$398.11
United
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$208.93
Typical High
$323.59
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$338.84