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Massachusetts rates for HCPCS L8035

Custom breast prosthesis, post mastectomy, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,886.12 / $1,886.12 / $1,886.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,886.12 / $1,989.26 / $3,434.97
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,862.24 / $11,528.79 / $20,671.75
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,946.45 / $3,126.16 / $4,215.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,713.42 / $5,574.29 / $7,178.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,109.32 / $3,628.59 / $3,628.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,026.28 / $3,060.59 / $3,172.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,234.23 / $2,234.23 / $5,127.38
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,495.10 / $3,495.10 / $3,669.86
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,180.12 / $5,180.12 / $5,180.12
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,978.18 / $20,671.75 / $20,671.75
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,784.24 / $2,307.46 / $4,215.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,874.82 / $2,315.03 / $4,215.60