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Washington rates for HCPCS L8035

Custom breast prosthesis, post mastectomy, molded to patient model

Facilitymedian $4,365 · 10th–90th $2,818–$10,4710%20%10th90th$4,365Professionalmedian $3,090 · 10th–90th $1,950–$6,3100%20%10th90th$3,090$1.0$5.0$20.0$100.0$500.0$2.0K$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
$2,818.38 / $2,818.38 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,398.83 / $3,890.45
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,168.69 / $4,168.69
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $4,897.79
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $5,623.41 / $12,302.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $5,128.61 / $9,120.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $4,365.16 / $4,365.16
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,168.69 / $4,365.16
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,365.16 / $4,365.16
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $6,309.57 / $8,709.64
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $4,168.69
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $4,897.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $6,456.54 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,630.27 / $3,801.89
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,090.30 / $6,606.93