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Minnesota rates for HCPCS L8035

Custom breast prosthesis, post mastectomy, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,398.83 / $3,715.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $4,466.84 / $6,456.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $4,466.84 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $16,595.87 / $39,810.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,888.44 / $6,456.54
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,882.50 / $16,595.87 / $30,902.95
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,128.61 / $6,918.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $4,466.84 / $8,128.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,949.84 / $4,786.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $2,630.27 / $5,370.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,187.76 / $5,128.61