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Washington rates for HCPCS L8030

Breast prosthesis, silicone or equal, without integral adhesive

Facilitymedian $389 · 10th–90th $263–$9550%20%10th90th$389Professionalmedian $295 · 10th–90th $182–$6310%20%10th90th$295$1.0$5.0$20.0$100.0$500.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $229.09 / $489.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $346.74 / $389.05
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $371.54 / $371.54
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $295.12
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $562.34 / $1,071.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $478.63 / $870.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $288.40 / $316.23
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $371.54 / $416.87
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $380.19 / $426.58
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $549.54 / $758.58
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $371.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $512.86 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $363.08
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $275.42 / $575.44