go back

Missouri rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.54 / $289.23 / $298.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.54 / $224.05 / $358.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.99 / $320.99 / $435.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.99 / $449.39 / $1,975.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.88 / $278.11 / $346.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.00 / $296.00 / $301.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.08 / $216.08 / $315.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.54 / $344.94 / $1,976.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.43 / $221.87 / $372.76
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$368.35 / $368.35 / $368.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.43 / $213.52 / $309.43