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Utah rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Facilitymedian $251 · 10th–90th $120–$4270%20%40%10th90th$251Professionalmedian $309 · 10th–90th $123–$1,9950%5%10%10th90th$309$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $309.03 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $295.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $309.03 / $407.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $426.58 / $426.58
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $302.00 / $426.58
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $426.58 / $436.52
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $436.52 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $229.09 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $190.55 / $346.74