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 Excellus 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 | Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1,343 | $125.86 – $4,433 |
| 2 | Highland Hospital Rochester, NY fee schedule · outpatient | 4 | $847.71 | $108.44 – $4,219 |
| 3 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $2,663 | $15.93 – $4,610 |
| 4 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $1,518 | $6.34 – $2,735 |
| 5 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $2,515 | $11.66 – $4,494 |
| 6 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $2,405 | $10.00 – $4,316 |
| 7 | MVHS, Inc. Utica, NY percent of total billed charges · bothfrom % of charges | 3 | $2,562 | $234.40 – $7,386 |
| 8 | Margaretville Memorial Hospital Margaretville, NY facility · fee schedule · outpatient | 2 | $1,712 | $330.00 – $4,620 |
| 9 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $6,617 | $27.50 – $11,868 |
| 10 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1,674 | $7.32 – $2,488 |
| 11 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $2,972 | $12.82 – $4,359 |
| 12 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $999.18 | $9.67 – $1,555 |
| 13 | Nazareth Hospital Philadelphia, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $6,694 | $27.50 – $11,868 |
| 14 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $1,979 | $11.00 – $3,974 |
| 15 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $2,137 | $17.75 – $3,225 |
| 16 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $902.90 | $7.50 – $1,363 |
| 17 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $2,130 | $17.75 – $3,225 |
| 18 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 3 | $2,422 | $5.00 – $5,450 |
| 19 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $603.61 | $1.44 – $965.34 |
| 20 | St Joseph Mercy Chelsea Chelsea, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $611.36 | $1.48 – $994.82 |
| 21 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $596.55 | $1.43 – $955.15 |
| 22 | St Joseph Mercy Oakland Pontiac, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1,206 | $5.20 – $2,135 |
| 23 | St Josephs Hospital Health Center Syracuse, NY facility · percent of total billed charges · bothfrom % of charges | 3 | $3,315 | $13.75 – $5,934 |
| 24 | St Mary Medical Center Langhorne, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $5,758 | $24.80 – $10,629 |
| 25 | St Mary Mercy Livonia Livonia, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $762.46 | $6.15 – $1,297 |
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