Mastectomy bra with built-in breast form at UnityPoint Health Marshalltown

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

Breast prosthesis bra & form

Marshalltown, IA

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Pricing by billing methodology

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How this price compares nationally

UnityPoint Health Marshalltown’s median price of $184 is 16% above the median hospital's median price ($158), higher than 79% of the 881 hospitals reporting HCPCS L8001. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L8001 at UnityPoint Health Marshalltown

Negotiated rates from the hospital’s own file: 6 payers, 15 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 hmo fee schedule · both	$75	$75	—	—	—	$75 – $75
2	UnitedHealthcare ppo fee schedule · both	$75	$75	—	—	—	$75 – $75
3	Wellmark commercial fee schedule · both	$148	$148	—	—	—	$148 – $148
4	Wellmark hmo fee schedule · both	$148	$148	—	—	—	$148 – $148
5	Wellmark ppo fee schedule · both	$148	$148	—	—	—	$148 – $148
6	Aetna hmo fee schedule · both	$168	$168	—	—	—	$168 – $168
7	Aetna ppo fee schedule · both	$168	$168	—	—	—	$168 – $168
8	Aetna medicare advantage case rate · outpatient	$184	$184	—	—	—	$184 – $184
9	Molina medicare advantage case rate · outpatient	$184	$184	—	—	—	$184 – $184
10	Wellmark medicare advantage case rate · outpatient	$184	$184	—	—	—	$184 – $184
11	Humana medicare advantage case rate · outpatient	$189	$189	—	—	—	$189 – $189
12	UnitedHealthcare medicare advantage case rate · outpatient	$189	$189	—	—	—	$189 – $189
13	Cigna commercial fee schedule · both	$191	$191	—	—	—	$191 – $191
14	UnitedHealthcare hmo fee schedule · outpatient	$216	$216	—	—	—	$216 – $216
15	UnitedHealthcare ppo fee schedule · outpatient	$216	$216	—	—	—	$216 – $216

Last updated: Jan 28, 2026

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