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Maryland rates for HCPCS L8031

Breast prosthesis, silicone or equal, with integral adhesive

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.88 / $207.16 / $334.04
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.77 / $298.77 / $298.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$277.45 / $277.45 / $277.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.54 / $202.54 / $277.45
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.06 / $388.65 / $559.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.20 / $203.58 / $310.66
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.17 / $250.17 / $272.06