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Breast Prosthesis, Silicone or Equal, No Integral Adhesive

Maine rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Rates data updated July 2026.

Facilitymedian $513 · 10th–90th $251$6460%20%10th90th$513Professionalmedian $295 · 10th–90th $191$4470%20%10th90th$295$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$229.09
Typical High
$338.84
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$602.56
Typical High
$676.08
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$302.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$295.12
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$524.81
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$245.47
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$239.88
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$416.87
Typical High
$446.68