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Breast Prosthesis, Silicone or Equal, No Integral Adhesive

New Hampshire rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Rates data updated July 2026.

Facilitymedian $513 · 10th–90th $282$6310%20%40%10th90th$513Professionalmedian $339 · 10th–90th $191$4470%20%10th90th$339$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
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$281.84
Typical High
$338.84
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$549.54
Typical High
$630.96
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$295.12
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
$812.83
United
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$251.19
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$316.23
Typical High
$446.68
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$549.54