Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type cost in Indiana
$54
Cash from
$54–$60
Cash range · 3 distinct prices
$89
Insurer rates from
16
Hospitals
Lowest published amounts at each hospital, from each hospital's own price file. Newest file: Mar 2026; each row shows its own date.
Prices by hospital
| Hospital | City | Cash | Insurer from | Data date |
|---|---|---|---|---|
| FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS | Indianapolis | $54 | $96 | Jan 2026288 days old |
| FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CARMEL | Carmel | $54 | $107 | Jan 2026288 days old |
| FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLE | Mooresville | $60 | $94 | Jan 2026288 days old |
| FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL - CARMEL | Carmel | $60 | $89 | Jul 2025472 days old |
| Indiana University Health North Hospital Inc. | Carmel | — | $151 | Mar 2026205 days old |
| Indiana University Health Bedford Inc. | Bedford | — | $151 | Mar 2026205 days old |
| Indiana University Health Frankfort Inc. | Frankfort | — | $151 | Mar 2026205 days old |
| Indiana University Health Jay Inc. | Portland | — | $151 | Mar 2026205 days old |
| Indiana University Health White Memorial Hospital Inc. | Monticello | — | $151 | Mar 2026205 days old |
| Indiana University Health West Hospital Inc. | Avon | — | $151 | Mar 2026205 days old |
| Indiana University Health Paoli Inc. | Paoli | — | $151 | Mar 2026205 days old |
| Indiana University Health Ball Memorial Hospital Inc. | Muncie | — | $151 | Mar 2026205 days old |
| Indiana University Health Bloomington Inc. | Bloomington | — | $151 | Mar 2026205 days old |
| Indiana University Health Tipton Hospital Inc. | Tipton | — | $151 | Mar 2026205 days old |
| Indiana University Health Inc. | Indianapolis | — | $151 | Mar 2026205 days old |
| Indiana University Health Arnett Inc. | Lafayette | — | $151 | Mar 2026205 days old |
Where this procedure name comes from
This is the HCPCS Level II descriptor published by CMS — a US government work in the public domain.
What the hospitals published for this code, in their own words:
- Beavercreek Medical CenterHc Breast Prosthesis, Mastectomy Bra, W/ Integrated Breast Prosthesis Form, Unilateral, Any Size, An
- Berger HospitalBreast prosthesis bra & form
- Bethesda Hospital Inc.Breast prosthesis bra & form
- Clinton Memorial HospitalBreast prosthesis bra & form
- Dayton Osteopathic HospitalHc Breast Prosthesis, Mastectomy Bra, W/ Integrated Breast Prosthesis Form, Unilateral, Any Size, An
- FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CARMELSupport-Surgi-Bra Breast Cotton White 2xlg 9179
- FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLISSupport-Surgi-Bra Breast Cotton White 2xlg 9179
- FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLESupport-Surgi-Bra Breast Cotton White 2xlg 9179
- FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL - CARMELSupport-Surgi-Bra Breast Cotton White 2xlg 9179
- Fairview HospitalBreast prosthesis bra & form
Compare prices near you
See published prices for this procedure near your ZIP, for your insurer or for cash, with the source and date of each.
Price it for me →Estimates from published hospital rates — not your exact bill.