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.
Original text from hospital filings
Breast prosthesis bra & form
Devils Lake, ND
See all hospitals reporting HCPCS L8001 →Price type
Altru Hospital Devils Lake’s median price of $156 is 1% below the median hospital's median price ($158), higher than 43% of the 881 hospitals reporting HCPCS L8001. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 10 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Medica medicaid managed care plan facility · fee schedule · outpatient | $52 | $52 | — | — | — | $52 – $52 |
| 2 | Medica medicaid managed care plan – hmo facility · fee schedule · outpatient | $52 | $52 | — | — | — | $52 – $52 |
| 3 | Medica medicare managed care plan facility · fee schedule · outpatient | $93 | $93 | — | — | — | $93 – $93 |
| 4 | Blue Cross Blue Shield all commercial plans facility · fee schedule · outpatient | $151 | $151 | — | — | — | $151 – $151 |
| 5 | Blue Cross Blue Shield medicaid managed care plan facility · fee schedule · outpatient | $151 | $151 | — | — | — | $151 – $151 |
| 6 | Medica all commercial plans facility · fee schedule · outpatient | $151 | $151 | — | — | — | $151 – $151 |
| 7 | Aetna medicare managed care plan facility · fee schedule · outpatient | $156 | $156 | — | — | — | $156 – $156 |
| 8 | Sanford Health Plan all commercial plans facility · fee schedule · outpatient | $214 | $214 | $31 | 15% | — | $182 – $245 |
| 9 | Aetna all commercial plans facility · fee schedule · outpatient | $223 | $223 | $59 | 26% | — | $164 – $281 |
| 10 | UnitedHealthcare all commercial plans facility · fee schedule · outpatient | $306 | $306 | — | — | — | $306 – $306 |
Last updated: Mar 1, 2026
See Mastectomy bra with built-in breast form pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.