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Breast Prosthesis, Silicone or Equal, with Integral Adhesive

Hawaii rates for HCPCS L8031

Breast prosthesis, silicone or equal, with integral adhesive

Rates data updated July 2026.

Facilitymedian $275 · 10th–90th $219$3980%20%40%10th90th$275Professionalmedian $513 · 10th–90th $141$5130%20%40%10th$513$200.0$500.0$1.0K

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
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$467.74
Typical High
$630.96
HMSA
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$512.86
Typical High
$707.95
United
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$251.19
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$302.00
Typical High
$616.60