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
$36
Median
$38
High
$71
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
10 hospitals; the 90th percentile is 59.6× 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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11 hospital rates
iThe hospitals that file a Medicaid 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 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $32 | $37 | $15 | 40% | — | $20 – $80 |
| 2 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $26 | $30 | $12 | 40% | — | $16 – $65 |
| 3 | Brookings Health System Brookings, SD fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 4 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 5 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 6 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $59 | $58 | $2 | 3% | — | $56 – $61 |
| 7 | Ohio State University Hospitals Columbus, OH fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 8 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $42 | $42 | $1 | 2% | — | $41 – $44 |
| 9 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $29 | $38 | $17 | 44% | — | $28 – $74 |
| 10 | Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges | 1 | $61 | $71 | $14 | 20% | — | $56 – $92 |
| 11 | UNIVERSITY OF MICHIGAN HEALTH Ann Arbor, MI facility · fee schedule · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
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