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Utah rates for HCPCS L8035

Custom breast prosthesis, post mastectomy, molded to patient model

Facilitymedian $2,630 · 10th–90th $1,259–$4,4670%20%40%10th90th$2,630Professionalmedian $3,162 · 10th–90th $1,259–$18,6210%10%10th90th$3,162$50.0$200.0$1.0K$5.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,398.83 / $18,620.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $3,090.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $3,235.94 / $4,168.69
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,466.84 / $4,466.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,162.28 / $4,897.79
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,466.84 / $4,570.88
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $4,570.88 / $5,248.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,290.87 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,949.84 / $3,311.31