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

Medicare pricing summary

Low

$44

Average

$101

Median

$45

High

$1.9k

Medicare rate distribution

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36 hospital rates

#		Plans
1	Tufts Medical Center BOSTON, MA other · both	1	$61	$71	$14	20%	15–150	$56 – $92
2	MELROSEWAKEFIELD HEALTHCARE Medford, MA other · both	1	$59	$58	$2	3%	8–80	$56 – $61
3	ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient	1	$5.5k	$5.5k	—	—	—	$5.5k – $5.5k
4	ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges	2	$27	$30	$14	45%	—	$13 – $79
5	CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
6	CATHOLIC HEALTH INITIATIVES COLORADO Pueblo, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
7	CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
8	CATHOLIC HEALTH INITIATIVES COLORADO West Valley City, UT fee schedule · outpatient	2	$44	$44	—	—	—	$44 – $44
9	CATHOLIC HEALTH INITIATIVES COLORADO West Jordan, UT fee schedule · outpatient	2	$44	$44	—	—	—	$44 – $44
10	CATHOLIC HEALTH INITIATIVES COLORADO Lehi, UT fee schedule · outpatient	2	$44	$44	—	—	—	$44 – $44
11	CATHOLIC HEALTH INITIATIVES COLORADO Layton, UT fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
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 Colorado Springs, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
16	CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient	2	$44	$44	—	—	—	$44 – $44
17	CATHOLIC HEALTH INITIATIVES COLORADO Fort Morgan, CO fee schedule · outpatient	1	$44	$44	—	—	—	$44 – $44
18	COMMONSPIRIT KANSAS, INC. Dodge City, KS fee schedule · outpatient	1	$45	$45	—	—	—	$45 – $45
19	COMMONSPIRIT KANSAS, INC. Garden City, KS fee schedule · outpatient	1	$45	$45	—	—	—	$45 – $45
20	Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient	1	$45	$45	—	—	—	$45 – $45
21	Grady Memorial Hospital Atlanta, GA facility · fee schedule · outpatient	1	$53	$53	—	—	—	$53 – $53
22	LONGMONT UNITED HOSPITAL Longmont, CO fee schedule · outpatient	1	$45	$45	—	—	—	$45 – $45
23	Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient	1	$45	$45	—	—	—	$45 – $45
24	Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient	1	$45	$45	—	—	—	$45 – $45
25	Mercy Hospital Joplin dba Mercy Hospital Joplin Joplin, MO facility · fee schedule · outpatient	1	$49	$49	—	—	—	$49 – $49

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HCPCS L8000