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
$29
Average
$251
Median
$65
High
$14.8k
Each hospital's average Highmark rate, under the methodology and billing class chosen below.
85 hospitals; the 90th percentile is 3.1× 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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115 hospital rates
iThe hospitals that file a Highmark 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 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $30 | $31 | $1 | 2% | 4–40 | $30 – $32 |
| 2 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 11 | $36 | $36 | — | — | — | $36 – $36 |
| 3 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 19 | $41 | $45 | $13 | 29% | — | $21 – $73 |
| 4 | Abington Memorial Hospital Abington, PA facility · fee schedule · outpatient | 2 | $52 | $69 | $28 | 40% | — | $47 – $108 |
| 5 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 6 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 3 | $74 | $74 | $22 | 31% | — | $43 – $103 |
| 7 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · inpatient | 11 | $36 | $36 | — | — | — | $36 – $36 |
| 8 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 19 | $40 | $45 | $12 | 27% | — | $21 – $69 |
| 9 | Camden-Clark Memorial Hospital Corporation Parkersburg, WV facility · other · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 10 | Charleston Area Medical Center Charleston, WV fee schedule · both | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 11 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 3 | $274 | $274 | $24 | 9% | — | $224 – $308 |
| 12 | City Hospital, Inc. Martinsburg, WV facility · other · outpatient | 2 | $46 | $46 | $0 | 0% | — | $46 – $46 |
| 13 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 2 | $58 | $65 | $23 | 35% | — | $43 – $98 |
| 14 | Davis Medical Center Elkins, WV facility · case rate · outpatient | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 15 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 16 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 2 | $90 | $90 | $5 | 6% | — | $85 – $95 |
| 17 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · inpatient | 11 | $36 | $36 | — | — | — | $36 – $36 |
| 18 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · outpatient | 19 | $41 | $56 | $27 | 48% | — | $35 – $105 |
| 19 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · other · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 20 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $112 | $137 | $59 | 43% | — | $89 – $235 |
| 21 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $36 | $36 | $1 | 2% | — | $35 – $37 |
| 22 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $82 | $100 | $43 | 43% | — | $65 – $172 |
| 23 | Holy Redeemer Health System Meadowbrook, PA facility · case rate · outpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 24 | JEFFERSON REGIONAL MEDICAL CENTER JEFFERSON HILLS, PA fee schedule · inpatient | 11 | $36 | $36 | — | — | — | $36 – $36 |
| 25 | JEFFERSON REGIONAL MEDICAL CENTER JEFFERSON HILLS, PA fee schedule · outpatient | 19 | $41 | $46 | $14 | 29% | — | $21 – $75 |
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