Silicone breast prosthesis with adhesive attachment

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Breast prosthesis w adhesive

Payers reporting HCPCS L8031

Payer pricing summary

Low

$120

Average

$481

Median

$445

High

$1.1k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +15 other terms	374	$410	$407	$112	28%	—	$1 – $1.3k
2	Aetna fee schedule · outpatient · +14 other terms	371	$415	$471	$231	49%	—	$1 – $2.6k
3	Humana fee schedule · outpatient · +13 other terms	329	$412	$602	$641	106%	—	$1 – $3.1k
4	WellCare fee schedule · outpatient · +4 other terms	219	$421	$434	$64	15%	—	$388 – $773
5	Blue Cross Blue Shield fee schedule · outpatient · +12 other terms	215	$412	$526	$270	51%	—	$0 – $2.0k
6	Devoted fee schedule · outpatient · +2 other terms	165	$408	$413	$13	3%	—	$404 – $525
7	Molina fee schedule · outpatient · +8 other terms	139	$601	$559	$222	40%	—	$1 – $1.1k
8	Cigna Healthspring fee schedule · outpatient · +3 other terms	116	$417	$417	$17	4%	—	$404 – $530
9	Cigna fee schedule · outpatient · +10 other terms	102	$427	$472	$130	28%	—	$386 – $1.3k
10	Anthem fee schedule · outpatient · +9 other terms	81	$427	$591	$567	96%	—	$317 – $3.2k
11	Kaiser fee schedule · outpatient · +7 other terms	69	$445	$644	$428	66%	—	$386 – $2.8k
12	Caresource fee schedule · outpatient · +7 other terms	46	$409	$429	$139	32%	—	$1 – $665
13	Ambetter facility · fee schedule · outpatient · +5 other terms	43	$664	$762	$165	22%	—	$396 – $1.1k
14	Clover fee schedule · outpatient · +3 other terms	42	$417	$411	$22	5%	—	$388 – $515
15	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$429	$429	$2	0%	—	$400 – $429
16	Oscar fee schedule · outpatient · +4 other terms	36	$424	$487	$133	27%	—	$400 – $795
17	Optum fee schedule · outpatient · +4 other terms	33	$419	$543	$211	39%	—	$396 – $1.0k
18	Medicare fee schedule · outpatient · +3 other terms	23	$419	$413	$11	3%	—	$397 – $427
19	Regence facility · fee schedule · outpatient · +3 other terms	19	$453	$426	$48	11%	—	$322 – $462
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$484	$472	$25	5%	—	$404 – $484
21	Bcbs Tx fee schedule · outpatient	18	$400	$400	—	—	—	$400 – $400
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$430	$496	$123	25%	—	$234 – $680
23	Tricare facility · fee schedule · outpatient · +2 other terms	14	$396	$397	$16	4%	—	$356 – $427
24	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$391	$391	$91	23%	—	$190 – $459
25	Highmark facility · fee schedule · outpatient · +4 other terms	13	$653	$654	$267	41%	—	$381 – $1.1k

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