go back

Massachusetts rates for HCPCS L8031

Breast prosthesis, silicone or equal, with integral adhesive

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $218.78 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $218.78 / $354.81
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $489.78 / $2,187.76
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $338.84 / $512.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $724.44 / $2,187.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $467.74 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $204.17 / $275.42
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $676.08
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $489.78 / $2,187.76
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $338.84 / $512.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $281.84 / $512.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $302.00 / $446.68