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Wisconsin rates for HCPCS L8035

Custom breast prosthesis, post mastectomy, molded to patient model

Facilitymedian $4,467 · 10th–90th $3,981$8,1280%20%40%10th90th$4,467Professionalmedian $3,311 · 10th–90th $1,950$6,7610%10%20%10th90th$3,311$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
$2,238.72 / $2,238.72 / $2,238.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,238.72 / $3,715.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $7,413.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $5,011.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $10,471.29 / $22,387.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $6,456.54 / $8,511.38
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,630.78 / $5,623.41
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,011.87 / $6,165.95
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,466.84 / $20,892.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,818.38 / $4,897.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,079.46 / $7,079.46 / $7,079.46
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $5,128.61 / $8,912.51
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $6,760.83 / $12,302.69
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $8,912.51 / $20,892.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,466.84 / $22,387.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,951.21 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,187.76 / $3,715.35