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 Tricare 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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49 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $2,869 | $2,869 – $2,869 |
| 2 | Beaufort Memorial Hospital Beaufort, SC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $1,056 | $622.12 – $2,812 |
| 3 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 1 | $1,697 | $1,697 – $1,697 |
| 4 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $7,567 | $7,567 – $7,567 |
| 5 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $3,652 | $931.80 – $21,864 |
| 6 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $8,289 | $8,289 – $8,289 |
| 7 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $3,685 | $3,100 – $4,025 |
| 8 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $5,002 | $49.00 – $30,917 |
| 9 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $4,961 | $1,240 – $11,125 |
| 10 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3,483 | $3,483 – $3,483 |
| 11 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $7,806 | $7,806 – $7,806 |
| 12 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $2,691 | $16.09 – $4,657 |
| 13 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $2,541 | $11.78 – $4,540 |
| 14 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $2,440 | $849.00 – $3,501 |
| 15 | KAPLAN GENERAL HOSPITAL, INC ST, LA percent of total billed charges · outpatientfrom % of charges | 1 | $2,364 | $91.84 – $5,090 |
| 16 | Kaweah Health Medical Center Visalia, CA facility · fee schedule · outpatient | 1 | $4,586 | $3,947 – $5,225 |
| 17 | Kaweah Health Mental Health Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $4,586 | $3,947 – $5,225 |
| 18 | MCLAREN CARO REGION CARO, MI fee schedule | 1 | $2,088 | $2,088 – $2,088 |
| 19 | MCLAREN THUMB REGION AXE, MI fee schedule | 1 | $1,337 | $1,337 – $1,337 |
| 20 | McLeod Health Cheraw, SC percent of total billed charges · bothfrom % of charges | 1 | $4,730 | $171.95 – $22,313 |
| 21 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $2,188 | $138.29 – $4,298 |
| 22 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $2,642 | $170.64 – $5,130 |
| 23 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $1,908 | $113.41 – $3,883 |
| 24 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 1 | $2,073 | $121.25 – $4,262 |
| 25 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 1 | $2,838 | $159.48 – $5,955 |
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