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
$1
Average
$115
Median
$64
High
$6.9k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
437 hospitals; the 90th percentile is 4.5× 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.
Filter by billing methodology
Filter by billing class
583 hospital rates
iThe hospitals that file a Cigna 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 | 3 | $84 | $88 | $41 | 47% | 99–990 | $24 – $251 |
| 2 | Self Regional Healthcare Greenwood, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $239 | $238 | $29 | 12% | 55–550 | $170 – $288 |
| 3 | Inspira Medical Center Mullica Hill Hill, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $31 | $4 | 13% | 29–290 | $28 – $39 |
| 4 | Aurora West Allis Medical Center West Allis, WI percent of total billed charges · outpatientfrom % of charges | 2 | $165 | $169 | $50 | 29% | 28–280 | $38 – $226 |
| 5 | Massachusetts General Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $106 | $106 | $21 | 20% | 15–24 | $85 – $127 |
| 6 | Aurora Medical Center Grafton Grafton, WI percent of total billed charges · outpatientfrom % of charges | 2 | $132 | $129 | $12 | 9% | 12–120 | $117 – $157 |
| 7 | Aurora BayCare Medical Center Green Bay, WI percent of total billed charges · outpatientfrom % of charges | 2 | $77 | $77 | $14 | 18% | 10–100 | $50 – $103 |
| 8 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $65 | $75 | $18 | 24% | 5–50 | $65 – $111 |
| 9 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $116 | $116 | — | — | 4–40 | $116 – $116 |
| 10 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 2 | $77 | $97 | $42 | 43% | 4–40 | $59 – $172 |
| 11 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 1 | $74 | $82 | $35 | 43% | 4–40 | $46 – $136 |
| 12 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO percent of total billed charges · inpatientfrom % of charges | 2 | $28 | $29 | $4 | 15% | 2–20 | $24 – $34 |
| 13 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO percent of total billed charges · outpatientfrom % of charges | 2 | $28 | $29 | $4 | 15% | 2–20 | $24 – $34 |
| 14 | CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO percent of total billed charges · inpatientfrom % of charges | 2 | $29 | $29 | $5 | 17% | 2–20 | $24 – $35 |
| 15 | CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO percent of total billed charges · outpatientfrom % of charges | 2 | $29 | $29 | $5 | 17% | 2–20 | $24 – $35 |
| 16 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO percent of total billed charges · inpatientfrom % of charges | 1 | $30 | $30 | $5 | 16% | 2–20 | $25 – $35 |
| 17 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO percent of total billed charges · outpatientfrom % of charges | 1 | $30 | $30 | $5 | 16% | 2–20 | $25 – $35 |
| 18 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $96 | $96 | — | — | 2–20 | $96 – $96 |
| 19 | OU Health - University of Oklahoma Medical Center Edmond, OK facility · percent of total billed charges · outpatientfrom % of charges | 2 | $176 | $176 | — | — | 2–20 | $176 – $176 |
| 20 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 2 | $150 | $163 | $111 | 68% | 2–20 | $48 – $305 |
| 21 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $161 | $161 | — | — | 2–20 | $161 – $161 |
| 22 | Indiana University Health Inc. Martinsville, IN percent of total billed charges · outpatientfrom % of charges | 6 | $479 | $1.8k | $7.8k | 438% | 1–10 | $108 – $48.7k |
| 23 | Indiana University Health North Hospital Inc. Carmel, IN percent of total billed charges · outpatientfrom % of charges | 6 | $479 | $652 | $1.0k | 159% | 1–10 | $108 – $6.7k |
| 24 | ALBANY GENERAL HOSPITAL Albany, OR professional · percent of total billed charges · outpatientfrom % of charges | 2 | $56 | $56 | — | — | — | $56 – $56 |
| 25 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 2 | $64 | $64 | $17 | 26% | — | $47 – $80 |
← Payers reporting HCPCS L8000 · Snapshot 20261111T120946Z-9134e7f7