Mastectomy bra

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.

Generation details were not recorded for this description.

Original text from hospital filings

BREAST PROSTHESIS, MASTECTOMY BRA, WITHOUT INTEGRATED BREAST PROSTHESIS FORM, ANY SIZE, ANY TYPE

Kaiser pricing summary

Low

$29

Average

$80

Median

$63

High

$371

Kaiser rate distribution

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178 hospital rates

#		Plans
1	Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges	3	$78	$96	$42	43%	31–103	$60 – $172
2	BAKERSFIELD MEMORIAL HOSPITAL Bakersfield, CA fee schedule · outpatient	2	$44	$44	—	—	—	$44 – $44
3	Boulder Community Health Lafayette, CO facility · case rate · outpatient	3	$88	$81	$29	36%	—	$47 – $113
4	Boulder Community Health Lafayette, CO professional · fee schedule · both	2	$54	$54	$5	8%	—	$50 – $59
5	CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
6	CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO percent of total billed charges · inpatientfrom % of charges	3	$26	$26	$5	18%	—	$20 – $34
7	CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO percent of total billed charges · outpatientfrom % of charges	3	$41	$40	$7	17%	—	$32 – $52
8	CATHOLIC HEALTH INITIATIVES COLORADO Pueblo, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
9	CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
10	CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO percent of total billed charges · inpatientfrom % of charges	1	$35	$35	—	—	—	$35 – $35
11	CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO percent of total billed charges · outpatientfrom % of charges	1	$35	$35	—	—	—	$35 – $35
12	CATHOLIC HEALTH INITIATIVES COLORADO Frisco, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
13	CATHOLIC HEALTH INITIATIVES COLORADO Durango, CO fee schedule · outpatient	1	$45	$45	—	—	—	$45 – $45
14	CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
15	CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO percent of total billed charges · inpatientfrom % of charges	3	$27	$27	$5	20%	—	$20 – $36
16	CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO percent of total billed charges · outpatientfrom % of charges	3	$42	$41	$8	19%	—	$32 – $54
17	CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
18	CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO percent of total billed charges · inpatientfrom % of charges	1	$42	$42	$7	16%	—	$35 – $49
19	CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO percent of total billed charges · outpatientfrom % of charges	1	$42	$42	$7	16%	—	$35 – $49
20	CATHOLIC HEALTH INITIATIVES COLORADO Fort Morgan, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
21	CENTENNIAL HOSPITAL A CAMPUS OF TMCA ENGLEWOOD, CO fee schedule · outpatient	1	$47	$47	—	—	—	$47 – $47
22	CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient	2	$60	$60	—	—	—	$60 – $60
23	COMMONSPIRIT KANSAS, INC. Dodge City, KS fee schedule · outpatient	1	$45	$45	—	—	—	$45 – $45
24	COMMONSPIRIT KANSAS, INC. Garden City, KS fee schedule · outpatient	1	$45	$45	—	—	—	$45 – $45
25	COMMUNITY HOSPITAL OF SAN BERNARDINO San Bernardino, CA fee schedule · inpatient	1	$121	$130	$48	37%	—	$71 – $208

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HCPCS L8000