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Breast Prosthesis, Silicone or Equal, No Integral Adhesive

Missouri rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Rates data updated July 2026.

Facilitymedian $347 · 10th–90th $195$8130%20%10th90th$347Professionalmedian $269 · 10th–90th $195$5130%20%10th90th$269$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
$194.98
Median
$288.40
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$239.88
Typical High
$1,995.26
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$363.08
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$436.52
Typical High
$1,513.56
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$275.42
Typical High
$398.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$436.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$436.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$295.12
Medica
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$338.84
Typical High
$954.99
Medica
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$213.80
Typical High
$2,187.76
United
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$346.74
Typical High
$436.52
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$213.80
Typical High
$338.84