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
Grayling, MI
See all hospitals reporting HCPCS L8002 →Price type
Munson Healthcare Grayling’s median price of $242 is 17% above the median hospital's median price ($208), higher than 81% 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, 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 | UnitedHealthcare commercial professional · fee schedule · both | $95 | $95 | — | — | — | $95 – $95 |
| 2 | Aetna commercial professional · fee schedule · both | $125 | $125 | — | — | — | $125 – $125 |
| 3 | Blue Cross Blue Shield managed medicaid facility · fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 4 | Molina managed medicaid facility · fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 5 | UnitedHealthcare managed medicaid facility · fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 6 | UnitedHealthcare medicare advantage professional · fee schedule · both | $129 | $129 | — | — | — | $129 – $129 |
| 7 | Blue Cross Blue Shield commercial professional · fee schedule · both | $229 | $229 | — | — | — | $229 – $229 |
| 8 | Aetna medicare advantage facility · fee schedule · outpatient | $242 | $242 | — | — | — | $242 – $242 |
| 9 | Humana medicare advantage facility · fee schedule · outpatient | $242 | $242 | — | — | — | $242 – $242 |
| 10 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $242 | $242 | — | — | — | $242 – $242 |
| 11 | WellCare medicare advantage facility · fee schedule · outpatient | $242 | $242 | — | — | — | $242 – $242 |
| 12 | Molina medicare advantage facility · fee schedule · outpatient | $261 | $261 | — | — | — | $261 – $261 |
Last updated: Apr 17, 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.