go back

Nebraska rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.94 / $272.94 / $461.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.90 / $272.94 / $272.94
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.99 / $320.99 / $320.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$376.16 / $413.77 / $417.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.00 / $470.79 / $470.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.00 / $470.79 / $725.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.43 / $464.00 / $1,976.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.94 / $251.88 / $355.87
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$469.42 / $470.79 / $593.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.46 / $556.39 / $969.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.94 / $213.52 / $339.62