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 Medical Mutual 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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70 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Benefis Hospitals Inc Helena, MT percent of total billed charges · bothfrom % of charges | 1 | $4,401 | $173.25 – $9,833 |
| 2 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $1,046 | $8.68 – $1,576 |
| 3 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $1,044 | $8.68 – $1,576 |
| 4 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $2,215 | $18.40 – $3,343 |
| 5 | Columbus Regional Hospital Columbus, IN percent of total billed charges · bothfrom % of charges | 1 | $3,679 | $2,810 – $4,114 |
| 6 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $2,631 | $22.33 – $4,098 |
| 7 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $1,922 | $15.22 – $3,284 |
| 8 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $6,403 | $1,006 – $14,505 |
| 9 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6,403 | $1,006 – $14,505 |
| 10 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 2 | $1,632 | $352.26 – $1,948 |
| 11 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 3 | $1,394 | $55.20 – $3,285 |
| 12 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 4 | $1,293 | $48.00 – $3,285 |
| 13 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 1 | $1,770 | $167.20 – $2,518 |
| 14 | Mayo Clinic Health System Eau Claire 54703-5270 facility · percent of total billed charges · bothfrom % of charges | 2 | $1,731 | $475.00 – $2,388 |
| 15 | Mayo Clinic Health System Sparta, WI facility · percent of total billed charges · bothfrom % of charges | 3 | $2,075 | $167.20 – $3,007 |
| 16 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $2,703 | $11.82 – $4,019 |
| 17 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $3,112 | $13.43 – $4,565 |
| 18 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1,298 | $12.56 – $2,019 |
| 19 | Mercy Health Services-Iowa Corp. Mason City, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $1,580 | $13.13 – $2,385 |
| 20 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $2,765 | $22.98 – $4,174 |
| 21 | Mercy Medical Center - Dubuque Dubuque, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $2,513 | $20.88 – $3,793 |
| 22 | Mercy Medical Center - Dyersville Dyersville, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $2,489 | $20.68 – $3,756 |
| 23 | Mercy Medical Center - New Hampton New Hampton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $2,387 | $18.90 – $4,078 |
| 24 | Mercy Medical Center - Newton Newton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $2,820 | $23.43 – $4,256 |
| 25 | Mercy Medical Center-Clinton Inc Clinton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $2,633 | $21.88 – $3,974 |
← Payers reporting HCPCS C1789 · Snapshot 20261108T055240Z-43b7dac7