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
BREAST PROSTHESIS, SILICONE OR EQUAL, WITHOUT INTEGRAL ADHESIVE
Low
$476
Average
$1.1k
Median
$1.1k
High
$1.9k
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
12 hospitals; the 90th percentile is 2.4× 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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14 hospital rates
iThe hospitals that file a Excellus 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 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 2 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 2 | $654 | $654 | $258 | 39% | — | $396 – $913 |
| 3 | Mount Carmel East Reynoldsburg, OH facility · fee schedule · both | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 4 | Mount Carmel East Reynoldsburg, OH facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 5 | Mount Carmel Grove City Grove City, OH facility · fee schedule · both | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 6 | Mount Carmel Grove City Grove City, OH facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 7 | Mount Carmel St Ann's Lewis Center, OH facility · fee schedule · both | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 8 | Newark-Wayne Community Hospital Newark, NY facility · fee schedule · outpatient | 1 | $825 | $825 | — | — | — | $825 – $825 |
| 9 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · fee schedule · both | 1 | $476 | $476 | — | — | — | $476 – $476 |
| 10 | Samaritan Medical Center Watertown, NY facility · case rate · outpatient | 2 | $1.1k | $1.1k | $711 | 64% | — | $396 – $1.8k |
| 11 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · fee schedule · both | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 12 | St Joseph Mercy Chelsea Chelsea, MI facility · fee schedule · both | 1 | $883 | $883 | — | — | — | $883 – $883 |
| 13 | St Mary Mercy Livonia Livonia, MI facility · fee schedule · both | 1 | $673 | $673 | — | — | — | $673 – $673 |
| 14 | United Memorial Medical Center Batavia, NY facility · fee schedule · outpatient | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
← Payers reporting HCPCS L8030 · Snapshot 20261111T120946Z-9134e7f7