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
IMPLANT-BREAST SILICONE-GEL STYLE-410LX LOW-HEIGHT-EXTRA-FULL-PROJECTION-PROFILE TEXTURED STERILE HIGHLY-COHESIVE GUMMY-BEAR-TYPE 405CC
The hospitals that file a Devoted rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.
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30 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Banner Payson Medical Center Payson, AZ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2,683 | $1,215 – $4,179 |
| 2 | Boulder Community Health Lafayette, CO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $1,523 | $266.00 – $2,492 |
| 3 | Boulder Community Health Lafayette, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1,523 | $266.00 – $2,492 |
| 4 | Clarion Hospital Clarion, PA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $2,912 | $2,912 – $2,912 |
| 5 | Dickenson Community Hospital CLINTWOOD, VA percent of total billed charges · bothfrom % of charges | 1 | $3,788 | $591.31 – $6,909 |
| 6 | East Cooper Medical Center LLC Mt Pleasant, SC percent of total billed charges · bothfrom % of charges | 2 | $3,469 | $2,062 – $5,306 |
| 7 | East Morgan County Hospital Brush, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2,814 | $1,275 – $4,382 |
| 8 | Hancock County Hospital SNEEDVILLE, TN percent of total billed charges · bothfrom % of charges | 1 | $8,964 | $1,399 – $16,352 |
| 9 | Honokaa Hospital and Skilled Nursing Facility Honokaa, HI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1,330 | $147.00 – $3,150 |
| 10 | Johnson County Community Hospital MOUNTAIN CITY, TN percent of total billed charges · bothfrom % of charges | 1 | $3,662 | $571.59 – $6,679 |
| 11 | Kau Hospital Pahala, HI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $538.25 | $59.50 – $1,275 |
| 12 | Lancaster General Health Lancaster, PA facility · other · outpatient | 1 | $768.27 | $142.40 – $1,950 |
| 13 | Lee County Community Hospital PENNINGTON GAP, VA percent of total billed charges · bothfrom % of charges | 1 | $2,778 | $433.62 – $5,067 |
| 14 | MID-VALLEY HEALTHCARE INC Lebanon, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $709.27 | $150.08 – $1,464 |
| 15 | Mercy Hospital Booneville Booneville, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $479.15 | $294.47 – $1,224 |
| 16 | Missouri Baptist Sullivan Hospital Sullivan, MO percent of total billed charges · bothfrom % of charges | 1 | $575.85 | $97.20 – $972.04 |
| 17 | Northwest Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $1,403 | $244.50 – $3,073 |
| 18 | Northwest Sahurita Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $1,403 | $244.50 – $3,073 |
| 19 | Oro Valley Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $1,403 | $244.50 – $3,073 |
| 20 | Page Hospital Page, AZ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3,468 | $1,571 – $5,401 |
| 21 | SAMARITAN NORTH LINCOLN HOSPITAL Lincoln City, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $880.47 | $186.30 – $1,817 |
| 22 | SAMARITAN PACIFIC HEALTH SERVICES INC Newport, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $807.10 | $170.78 – $1,666 |
| 23 | SID Peterson Memorial Hospital Kerrville, TX facility · percent of total billed charges · inpatientfrom % of charges | 1 | $3,397 | $2,425 – $5,789 |
| 24 | SID Peterson Memorial Hospital Kerrville, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3,397 | $2,425 – $5,789 |
| 25 | South Carolina Coastal Medical Center LLC Hardeeville, SC percent of total billed charges · bothfrom % of charges | 2 | $3,494 | $2,205 – $4,647 |
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