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
Pittsfield, ME
See all hospitals reporting HCPCS L8002 →Price type
Sebasticook Valley Health’s median price of $122 is 41% below the median hospital's median price ($208), higher than 4% 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: 4 payers, 8 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 | Anthem commercial professional · fee schedule · outpatient | $91 | $75 | $46 | 62% | — | $12 – $122 |
| 2 | Anthem enhanced pathways professional · fee schedule · outpatient | $91 | $75 | $46 | 62% | — | $12 – $122 |
| 3 | Cigna commercial professional · fee schedule · outpatient | $88 | $88 | — | — | — | $88 – $88 |
| 4 | Aetna commercial professional · fee schedule · outpatient | $131 | $131 | — | — | — | $131 – $131 |
| 5 | Anthem enhanced pathways facility · fee schedule · outpatient | $188 | $188 | — | — | — | $188 – $188 |
| 6 | Cigna commercial facility · fee schedule · outpatient | $194 | $194 | — | — | — | $194 – $194 |
| 7 | Anthem commercial facility · fee schedule · outpatient | $241 | $241 | — | — | — | $241 – $241 |
| 8 | UnitedHealthcare commercial professional · fee schedule · outpatient | $269 | $269 | — | — | — | $269 – $269 |
Last updated: Mar 30, 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.