Deaconess Gateway Hospital — price list

← Hospital overviewVerified from Deaconess Gateway Hospital’s published price file

Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.

How to read these columns

List: The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
Cash: The discounted self-pay price for paying directly, without insurance.
Negotiated: Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.

These are the hospital’s published reference prices, not a personalized estimate of your bill.

41 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
HC EXPANDER BREAST ALLERGAN 133MX-13-T Inpatient	C1789 HCPCS	$3,396	$1,121	$1,121 – $2,988	—
HC EXPANDER BREAST ALLERGAN 133MX-15-T Inpatient	C1789 HCPCS	$3,216	$1,061	$1,061 – $2,830	—
HC EXPANDER BREAST ALLERGAN 133SX-12-T Inpatient	C1789 HCPCS	$3,216	$1,061	$1,061 – $2,830	—
HC EXPANDER BREAST MENTOR 354-7111 Inpatient	C1789 HCPCS	$3,194	$1,054	$1,054 – $2,811	—
HC EXPANDER BREAST MENTOR 354-7212 Inpatient	C1789 HCPCS	$3,194	$1,054	$1,054 – $2,811	—
HC IMPLANT BREAST ALLERGAN GEL 115-272 Inpatient	C1789 HCPCS	$1,652	$545	$545 – $1,454	—
HC IMPLANT BREAST ALLERGAN GEL 20-300 Inpatient	C1789 HCPCS	$1,607	$530	$530 – $1,414	—
HC IMPLANT BREAST ALLERGAN GEL 20-325 Inpatient	C1789 HCPCS	$1,607	$530	$530 – $1,414	—
HC IMPLANT BREAST ALLERGAN GEL 20-425 Inpatient	C1789 HCPCS	$1,742	$575	$575 – $1,533	—
HC IMPLANT BREAST ALLERGAN GEL 68-330 Inpatient	C1789 HCPCS	$845	$279	$279 – $744	—
HC IMPLANT BREAST ALLERGAN GEL MF-410580 Inpatient	C1789 HCPCS	$2,692	$888	$888 – $2,369	—
HC IMPLANT BREAST ALLERGAN GEL MF-410640 Inpatient	C1789 HCPCS	$2,692	$888	$888 – $2,369	—
HC IMPLANT BREAST ALLERGAN GEL MX-410195 Inpatient	C1789 HCPCS	$2,150	$710	$710 – $1,892	—
HC IMPLANT BREAST ALLERGAN GEL SCL-110 Inpatient	C1789 HCPCS	$2,034	$671	$671 – $1,790	—
HC IMPLANT BREAST ALLERGAN GEL SCLP-590 Inpatient	C1789 HCPCS	$2,091	$690	$690 – $1,840	—
HC IMPLANT BREAST ALLERGAN GEL SRLP-190 Inpatient	C1789 HCPCS	$1,586	$523	$523 – $1,396	—
HC IMPLANT BREAST ALLERGAN GEL SRM-295 Inpatient	C1789 HCPCS	$1,529	$505	$505 – $1,346	—
HC IMPLANT BREAST ALLERGAN GEL SRX-470 Inpatient	C1789 HCPCS	$1,627	$537	$537 – $1,432	—
HC IMPLANT BREAST ALLERGAN GEL SRX-560 Inpatient	C1789 HCPCS	$1,627	$537	$537 – $1,432	—
HC IMPLANT BREAST ALLERGAN GEL SRX-800 Inpatient	C1789 HCPCS	$1,826	$603	$603 – $1,607	—
HC IMPLANT BREAST ALLERGAN GEL SSF-695 Inpatient	C1789 HCPCS	$1,849	$610	$610 – $1,627	—
HC IMPLANT BREAST ALLERGAN GEL TRF-265 Inpatient	C1789 HCPCS	$1,586	$523	$523 – $1,396	—
HC IMPLANT BREAST ALLERGAN GEL TRM-310 Inpatient	C1789 HCPCS	$1,586	$523	$523 – $1,396	—
HC IMPLANT BREAST ALLERGAN GEL TRM-330 Inpatient	C1789 HCPCS	$1,586	$523	$523 – $1,396	—
HC IMPLANT BREAST ALLERGAN SALINE 68HP-550 Inpatient	C1789 HCPCS	$1,555	$513	$513 – $1,368	—
HC IMPLANT BREAST MENTOR GEL 334-1109 Inpatient	C1789 HCPCS	$2,518	$831	$831 – $2,216	—
HC IMPLANT BREAST MENTOR GEL 334-1402 Inpatient	C1789 HCPCS	$2,997	$989	$989 – $2,637	—
HC IMPLANT BREAST MENTOR GEL SMPX465 Inpatient	C1789 HCPCS	$2,178	$719	$719 – $1,917	—
HC IMPLANT BREAST SIENTRA GEL 20621-415HP Inpatient	C1789 HCPCS	$1,502	$496	$496 – $1,322	—
HC MESH CQUR 6X8 31533 Inpatient	C1781 HCPCS	$1,342	$443	$443 – $1,181	$631