go back

Breast Prosthesis, Silicone or Equal, No Integral Adhesive

Oklahoma rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Rates data updated July 2026.

Facilitymedian $219 · 10th–90th $170$4680%20%10th90th$219Professionalmedian $229 · 10th–90th $158$3470%10%20%10th90th$229$100.0$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
$169.82
Median
$169.82
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$194.98
Typical High
$229.09
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$467.74
Medica
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$1,230.27
Medica
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$199.53
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$323.59
Typical High
$436.52
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$190.55
Typical High
$281.84