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 Optum 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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87 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $159.50 | $159.50 – $159.50 |
| 2 | Affinity Hospital LLC Birmingham, AL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $14,200 | $1,573 – $30,923 |
| 3 | Banner Churchill Community Hospital Fallon, NV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1,904 | $862.40 – $2,965 |
| 4 | Baylor Scott & White Medical Center - Plano Plano, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2,797 | $205.21 – $12,134 |
| 5 | Baylor University Medical Center Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2,797 | $205.21 – $12,134 |
| 6 | Bexar County Hospital District San Antonio, TX percent of total billed charges · outpatientfrom % of charges | 1 | $6,224 | $1,875 – $13,281 |
| 7 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 3 | $2,490 | $2,084 – $2,725 |
| 8 | Boston Children's Hospital Lexington, MA percent of total billed charges · bothfrom % of charges | 3 | $2,490 | $2,084 – $2,725 |
| 9 | Boston Children's Hospital Brookline, MA percent of total billed charges · bothfrom % of charges | 3 | $2,490 | $2,084 – $2,725 |
| 10 | Boston Children's Hospital Dartmouth, MA percent of total billed charges · bothfrom % of charges | 3 | $2,490 | $2,084 – $2,725 |
| 11 | Boston Children's Hospital Boston, MA case rate · both | 1 | $4,231 | $4,231 – $4,231 |
| 12 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 3 | $2,490 | $2,084 – $2,725 |
| 13 | Boston Children's Hospital Peabody, MA percent of total billed charges · bothfrom % of charges | 3 | $2,490 | $2,084 – $2,725 |
| 14 | Boston Children's Hospital Waltham, MA percent of total billed charges · bothfrom % of charges | 3 | $2,490 | $2,084 – $2,725 |
| 15 | Boston Children's Hospital Needham, MA percent of total billed charges · bothfrom % of charges | 3 | $2,490 | $2,084 – $2,725 |
| 16 | Boston Children's Hospital Weymouth, MA percent of total billed charges · bothfrom % of charges | 3 | $2,490 | $2,084 – $2,725 |
| 17 | CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER Houston, TX fee schedule · outpatient | 3 | $5,224 | $0.27 – $17,741 |
| 18 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $279.28 | $279.28 – $279.28 |
| 19 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $171.53 | $171.53 – $171.53 |
| 20 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $175.26 | $175.26 – $175.26 |
| 21 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $182.61 | $182.61 – $182.61 |
| 22 | Childrens Hospital of Los Angeles Angeles, CA facility · per diem · outpatient | 1 | $347.23 | $168.00 – $475.00 |
| 23 | DIGNITY HEALTH Phoenix, AZ fee schedule · outpatient | 1 | $1,665 | $556.48 – $3,505 |
| 24 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient | 1 | $1,294 | $0.01 – $2,639 |
| 25 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $1,739 | $1,739 – $1,739 |
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