Mastectomy bra with breast form at Samaritan 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

CAMISOLE MASTECTOMY WHT/L POST-SURG GENTAL TOUCH

Troy, NY

See all hospitals reporting HCPCS L8015 →

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Pricing by billing methodology

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How this price compares nationally

Samaritan Hospital’s median price of $36 is 52% below the median hospital's median price ($76), higher than 2% of the 972 hospitals reporting HCPCS L8015. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L8015 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 16 payers, 30 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	Aetna aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges	$20	$21	$1	5%	—	$20 – $23
2	Aetna aetna facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
3	Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
4	Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
5	Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
6	Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
7	Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
8	Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
9	Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
10	Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
11	Medical Mutual aetna facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
12	Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
13	Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
14	UnitedHealthcare uhc essential plan medicaid facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
15	UnitedHealthcare united healthcare medicaid harp chip facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
16	Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
17	Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$33	$34	$2	5%	—	$32 – $36
18	Excellus blue shield of ne new york medicare adv facility · percent of total billed charges · bothfrom % of charges	$41	$42	$2	5%	—	$40 – $45
19	Highmark blue shield of ne new york medicare adv facility · percent of total billed charges · bothfrom % of charges	$41	$42	$2	5%	—	$40 – $45
20	WellCare wellcare ep 1&2 medicaid facility · percent of total billed charges · bothfrom % of charges	$61	$63	$3	5%	—	$60 – $68
21	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$65	$65	$19	30%	—	$44 – $90
22	First Health first health facility · percent of total billed charges · bothfrom % of charges	$65	$67	$3	5%	—	$65 – $72
23	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$69	$71	$4	5%	—	$69 – $77
24	MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges	$73	$76	$4	5%	—	$73 – $81
25	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$73	$76	$4	5%	—	$73 – $81

Page 1 of 2 · 30 rates

Last updated: Mar 31, 2026

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