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Mastectomy Bra with Integrated Prosthesis Form, Bilateral

Montana rates for HCPCS L8002

Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type

Rates data updated July 2026.

How much does Mastectomy Bra with Integrated Prosthesis Form, Bilateral cost?

$170

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $170 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $195 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$162$102 to $195
FacilityA hospital or hospital-owned outpatient department$195$155 to $214

How much rates vary

Facilitymedian $195 · 10th to 90th $123 to $245Professionalmedian $162 · 10th to 90th $58 to $380
$100$200$500facility $195professional $162

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$162.18
Typical High
$851.14
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$213.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$213.80
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$194.98
Typical High
$380.19
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$194.98
Typical High
$380.19
Providence
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$154.88
Typical High
$288.40
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$158.49
Typical High
$213.80
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$117.49
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$89.13
Typical High
$141.25

Where Montana sits

The same service costs 3.8 times more in Kansas than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 9th of 51

$170

KS $331DE $87.10

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.