Mastectomy bra with built-in breast forms, both sides at Clarion Hospital

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

Brst prsth bra & bilat form

Clarion, PA

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How this price compares nationally

Clarion Hospital’s median price of $202 is 3% below the median hospital's median price ($208), higher than 33% of the 863 hospitals reporting HCPCS L8002. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L8002 at Clarion Hospital

Negotiated rates from the hospital’s own file: 7 payers, 12 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	Medicaid traditional medicaid facility · case rate · outpatient	$104	$104	—	—	—	$104 – $104
2	Cigna commercial facility · fee schedule · outpatient	$194	$194	—	—	—	$194 – $194
3	Tricare tricare facility · fee schedule · outpatient	$194	$194	—	—	—	$194 – $194
4	UnitedHealthcare commercial facility · fee schedule · outpatient	$194	$194	—	—	—	$194 – $194
5	UnitedHealthcare mcr advantage facility · fee schedule · outpatient	$194	$194	—	—	—	$194 – $194
6	Aetna mcr advantage facility · fee schedule · outpatient	$200	$200	—	—	—	$200 – $200
7	Devoted mcr advantage facility · fee schedule · outpatient	$206	$206	—	—	—	$206 – $206
8	Aetna auto network facility · fee schedule · outpatient	$214	$214	—	—	—	$214 – $214
9	Aetna commercial facility · fee schedule · outpatient	$254	$254	—	—	—	$254 – $254
10	Highmark mcr advantage facility · fee schedule · outpatient	$194	$274	$115	42%	—	$192 – $436
11	Highmark chip facility · fee schedule · outpatient	$322	$322	—	—	—	$322 – $322
12	Aetna hmo facility · fee schedule · outpatient	$447	$447	—	—	—	$447 – $447

Last updated: Jan 1, 2026

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See Mastectomy bra with built-in breast forms, both sides pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.