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.
Generation details were not recorded for this description.
Original text from hospital filings
BREAST PROSTHESIS, MASTECTOMY BRA, WITHOUT INTEGRATED BREAST PROSTHESIS FORM, ANY SIZE, ANY TYPE
Low
$11
Average
$75
Median
$54
High
$1.6k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
837 hospitals; the 90th percentile is 2.6× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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1,033 hospital rates
iThe hospitals that file a Aetna 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.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Texas Health Arlington Memorial Hospital Arlington, TX percent of total billed charges · outpatientfrom % of charges | 5 | $55 | $59 | $37 | 63% | 99–990 | $5 – $187 |
| 2 | Texas Health Harris Methodist Hospital HurstEulessBedford Bedford, TX percent of total billed charges · outpatientfrom % of charges | 5 | $55 | $60 | $37 | 62% | 99–990 | $5 – $187 |
| 3 | St Mary Mercy Livonia Livonia, MI facility · percent of total billed charges · bothfrom % of charges | 4 | $49 | $51 | $13 | 25% | 20–65 | $36 – $83 |
| 4 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY percent of total billed charges · outpatientfrom % of charges | 3 | $63 | $61 | $30 | 48% | 17 | $21 – $130 |
| 5 | Aurora West Allis Medical Center West Allis, WI percent of total billed charges · outpatientfrom % of charges | 2 | $130 | $139 | $55 | 39% | 14–140 | $24 – $220 |
| 6 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 2 | $110 | $139 | $121 | 87% | 12–120 | $18 – $368 |
| 7 | Mount Carmel St Ann's Lewis Center, OH facility · percent of total billed charges · bothfrom % of charges | 5 | $64 | $80 | $47 | 59% | 12–120 | $21 – $258 |
| 8 | Aurora BayCare Medical Center Green Bay, WI percent of total billed charges · outpatientfrom % of charges | 2 | $55 | $64 | $20 | 31% | 10–100 | $32 – $100 |
| 9 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 4 | $39 | $42 | $13 | 30% | 9–90 | $31 – $80 |
| 10 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY percent of total billed charges · outpatientfrom % of charges | 3 | $92 | $85 | $48 | 56% | 6–60 | $21 – $191 |
| 11 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges | 3 | $97 | $91 | $49 | 53% | 6–60 | $25 – $200 |
| 12 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $67 | $67 | — | — | 4–40 | $67 – $67 |
| 13 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $78 | $97 | $42 | 43% | 4–40 | $60 – $172 |
| 14 | CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO other · inpatient | 1 | $49 | $49 | — | — | 2–20 | $49 – $49 |
| 15 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO percent of total billed charges · inpatientfrom % of charges | 2 | $41 | $43 | $8 | 19% | 2–20 | $31 – $53 |
| 16 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO percent of total billed charges · outpatientfrom % of charges | 2 | $38 | $40 | $8 | 20% | 2–20 | $28 – $52 |
| 17 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 3 | $55 | $67 | $23 | 35% | 2–20 | $45 – $102 |
| 18 | Mount Carmel St Ann's Lewis Center, OH facility · fee schedule · outpatient | 1 | $5.7k | $5.7k | — | — | 2–20 | $5.7k – $5.7k |
| 19 | West Virginia University Hospitals, Inc. Morgantown, WV facility · other · outpatient | 2 | $42 | $42 | $5 | 11% | 2–20 | $38 – $47 |
| 20 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $216 | $216 | — | — | 2–20 | $216 – $216 |
| 21 | Indiana University Health North Hospital Inc. Carmel, IN percent of total billed charges · outpatientfrom % of charges | 6 | $426 | $470 | $237 | 50% | 1–10 | $108 – $920 |
| 22 | Indiana University Health West Hospital Inc. Avon, IN percent of total billed charges · outpatientfrom % of charges | 6 | $517 | $1.7k | $7.1k | 426% | 1–10 | $108 – $44.0k |
| 23 | MCLAREN GREATER LANSING LANSING, MI percent of total billed chargesfrom % of charges | 1 | $148 | $148 | — | — | 1–10 | $148 – $148 |
| 24 | MCLAREN MACOMB CLEMENS, MI percent of total billed chargesfrom % of charges | 1 | $114 | $114 | — | — | 1–10 | $114 – $114 |
| 25 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $112 | $112 | — | — | 1–10 | $112 – $112 |
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