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Nebraska rates for HCPCS L8035

Custom breast prosthesis, post mastectomy, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,806.62 / $2,806.62 / $2,806.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,806.62 / $2,806.62 / $3,309.30
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,300.79 / $3,300.79 / $3,300.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,868.11 / $4,254.92 / $4,297.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,060.59 / $4,841.16 / $4,841.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,709.26 / $5,127.38 / $7,465.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,215.82 / $4,788.28 / $20,671.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,675.60 / $2,604.69 / $3,659.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,826.99 / $4,841.16 / $6,099.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,321.00 / $5,721.37 / $9,973.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,675.60 / $2,195.64 / $3,037.41