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
Brst prsth bra & bilat form
Edina, MN
See all hospitals reporting HCPCS L8002 →Price type
Fairview Health Services’s median price of $223 is 7% above the median hospital's median price ($208), higher than 75% of the 863 hospitals reporting HCPCS L8002. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 33 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 | Bcbs Mn pmap fee schedule · outpatient | $90 | $90 | — | — | — | $90 – $90 |
| 2 | Bcbs Mn aware federal fee schedule · both | $185 | $185 | — | — | — | $185 – $185 |
| 3 | Bcbs Mn aware/blue plus fee schedule · both | $188 | $188 | — | — | — | $188 – $188 |
| 4 | Medica managed medicaid/accessability fee schedule · both | $195 | $195 | — | — | — | $195 – $195 |
| 5 | Sanford Health Plan medicare advantage fee schedule · outpatient | $196 | $196 | — | — | — | $196 – $196 |
| 6 | UnitedHealthcare medicare advantage fee schedule · outpatient | $196 | $196 | — | — | — | $196 – $196 |
| 7 | WellCare medicare advantage fee schedule · outpatient | $196 | $196 | — | — | — | $196 – $196 |
| 8 | Ucare medicare advantage/msho fee schedule · outpatient | $199 | $199 | — | — | — | $199 – $199 |
| 9 | Bcbs Mn medicare advantage fee schedule · outpatient | $204 | $204 | — | — | — | $204 – $204 |
| 10 | Medica medicare advantage non-snp fee schedule · outpatient | $208 | $208 | — | — | — | $208 – $208 |
| 11 | Ucare pmap fee schedule · outpatient | $209 | $209 | — | — | — | $209 – $209 |
| 12 | Medica medicare advantage non-snp fee schedule · both | $211 | $211 | — | — | — | $211 – $211 |
| 13 | Bcbs Mn pmap fee schedule · both | $212 | $212 | — | — | — | $212 – $212 |
| 14 | Bcbs Mn aware federal fee schedule · outpatient | $213 | $213 | — | — | — | $213 – $213 |
| 15 | Medica msho/medicare advantage snp fee schedule · both | $215 | $215 | — | — | — | $215 – $215 |
| 16 | Bcbs Mn aware/blue plus fee schedule · outpatient | $216 | $216 | — | — | — | $216 – $216 |
| 17 | Ucare pmap fee schedule · both | $217 | $217 | — | — | — | $217 – $217 |
| 18 | Medica managed medicaid/accessability fee schedule · outpatient | $239 | $239 | — | — | — | $239 – $239 |
| 19 | Medica msho/medicare advantage snp fee schedule · outpatient | $259 | $259 | — | — | — | $259 – $259 |
| 20 | Ucare individual and family with m health fairview fee schedule · outpatient | $348 | $348 | — | — | — | $348 – $348 |
| 21 | Medica bold fee schedule · both | $367 | $367 | — | — | — | $367 – $367 |
| 22 | UnitedHealthcare commercial fee schedule · both | $370 | $370 | — | — | — | $370 – $370 |
| 23 | UnitedHealthcare core fee schedule · both | $370 | $370 | — | — | — | $370 – $370 |
| 24 | Medica vantage self insured fee schedule · both | $397 | $397 | — | — | — | $397 – $397 |
| 25 | Medica city of st. paul/essential-uplan fee schedule · both | $407 | $407 | — | — | — | $407 – $407 |
Last updated: Feb 6, 2026
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.