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Pennsylvania rates for HCPCS L8035

Custom breast prosthesis, post mastectomy, molded to patient model

Facilitymedian $4,571 · 10th–90th $1,905–$7,4130%20%10th90th$4,571Professionalmedian $2,188 · 10th–90th $1,905–$3,7150%20%40%10th90th$2,188$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $7,413.10 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,137.96 / $3,715.35
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,235.94 / $3,235.94
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,548.13 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,090.30 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $3,090.30
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $5,754.40 / $8,317.64
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,365.16
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,090.30 / $4,365.16
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,019.95 / $3,235.94
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,235.94 / $3,235.94
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,238.72 / $3,467.37
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $6,165.95 / $8,511.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $4,073.80
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $4,168.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $5,370.32 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,398.83 / $4,365.16