Breast reconstruction Cost by Hospital

Breast reconstruction is a surgical procedure. Prices are from 1264 US hospitals across 51 states, from their machine-readable files.

$8,440median cash price · 1264 hospitals, 51 statestypically $2,127–$29,143 depending on the hospital
≈ 6.9× Medicare · High vs MedicareFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$11,717
Cash / self-pay
$8,440
Insurer-negotiated
$9,729
Medicare pays
$1,227
$2,127$29,143
Median cash $8,440  ·  Medicare $1,227  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $8,440 — about 6.9× the Medicare rate ($1,227). High vs Medicare. A fair cash price is usually within ~2× Medicare ($2,455).

💡 Asking for the cash price instead of the $11,717 list price could save about $3,277 (28%).

Estimate what you’ll pay
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Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
East Jefferson General Hospital Metairie, LA $1,442 $2,176 ★ 2/5 157 min —
Southwestern Vermont Medical Center Bennington, VT $1,550 — ★ 3/5 202 min —
Yuma Regional Medical Center Yuma, AZ $1,550 $1,500 ★ 2/5 192 min —
Ste Genevieve County Memorial Hospital Sainte Genevieve, MO $1,582 $1,291 ★ 4/5 103 min —
North Central Surgical Center Llp Dallas, TX $1,598 $7,320 — 108 min —
Bayside Community Hospital Anahuac, TX $1,622 $929 — 106 min —
Vanderbilt Bedford Hospital Shelbyville, TN $1,638 $2,175 ★ 4/5 125 min —
Vanderbilt Tullahoma-Harton Hospital Tullahoma, TN $1,638 $2,319 ★ 3/5 168 min —
Southwest General Health Center Middleburg Heights, OH $1,640 $720 ★ 4/5 199 min —
West Jefferson Medical Center Marrero, LA $1,648 — ★ 3/5 147 min —
Cape Cod Hospital Hyannis, MA $1,662 $17,174 ★ 2/5 201 min —
Baylor Surgical Hospital at Las Colinas Irving, TX $1,676 $7,320 — 71 min —
Red Bud Regional Hospital Red Bud, IL $1,717 $3,009 ★ 4/5 122 min —
Deaconess Hospital Inc Evansville, IN $1,717 $1,562 ★ 2/5 186 min —
The Women's Hospital Newburgh, IN $1,717 $1,613 ★ 5/5 130 min —
Deaconess Henderson Hospital Henderson, KY $1,717 $1,610 ★ 2/5 127 min —
Boone Hospital Center Columbia, MO $1,732 — ★ 4/5 175 min —
Faith Regional Health Services Norfolk, NE $1,918 $15,709 ★ 3/5 101 min —
University Medical Center Las Vegas, NV $1,990 $1,952 ★ 2/5 238 min —
Ellis Hospital Schenectady, NY $2,010 $1,536 ★ 3/5 232 min —
Children's Mercy South Overland Park, KS $2,015 $2,330 — — —
The Children's Mercy Hospital Kansas City, MO $2,015 $2,330 — — —
Sisters of Charity Hospital Buffalo, NY $2,127 $1,163 ★ 3/5 203 min —
Kenmore Mercy Hospital Kenmore, NY $2,127 $1,108 ★ 3/5 236 min —
Mount St. Mary's Hospital & Health Center Lewiston, NY $2,127 $1,108 ★ 2/5 156 min —

CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated October 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.

What insurers pay for Breast reconstruction

Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $8,440; Medicare pays $1,227.

InsurerHospitalsNegotiated median
Medicaid 119
$376
$60 – $1,049
Medicare 214
$548
$88 – $2,952
Tricare / VA 134
$863
$123 – $16,738
Highmark 83
$939
$115 – $18,322
Univera 11
$942
$126 – $1,260
Health Net 95
$1,115
$122 – $24,219
Independent Health 16
$1,170
$730 – $3,763
AmeriHealth 117
$1,239
$210 – $14,789
Geisinger 34
$1,242
$102 – $16,551
Blue Cross Blue Shield 675
$1,502
$150 – $27,786
MVP Health Care 46
$1,525
$536 – $20,589
Sanford Health Plan 25
$1,554
$703 – $23,928
Priority Health 32
$1,607
$334 – $12,670
Molina Healthcare 364
$1,643
$134 – $16,076
Coventry 41
$1,797
$302 – $17,412
Workers' Comp / No-Fault 28
$2,025
$2,025 – $27,116
Centene / Ambetter 468
$2,323
$115 – $16,335
MultiPlan / PHCS network 182
$2,335
$158 – $28,258
Bright Health 36
$2,559
$1,876 – $5,766
HealthPartners 84
$2,585
$180 – $17,587
UCare 33
$2,837
$809 – $18,268
Medica 48
$3,123
$954 – $15,961
Anthem 330
$3,253
$157 – $18,272
Harvard Pilgrim 17
$4,645
$844 – $14,845
Amerigroup 111
$4,820
$905 – $14,536
SelectHealth 31
$4,882
$1,583 – $17,485
Humana 579
$4,955
$575 – $20,151
Aetna 760
$5,050
$753 – $16,947
Security Health Plan 23
$5,170
$827 – $17,707
UPMC Health Plan 55
$5,459
$1,115 – $20,498
Oscar Health 141
$6,587
$1,815 – $14,110
EmblemHealth 49
$6,608
$730 – $108,720
UnitedHealthcare 828
$7,534
$834 – $23,015
Healthcare Highways 31
$8,517
$2,069 – $14,320
Cigna 576
$9,541
$1,629 – $23,733
Kaiser Permanente 137
$14,535
$176 – $22,452
Devoted Health 103
$15,989
$1,430 – $18,598
AvMed 30
$20,955
$5,062 – $28,672

Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.

Where it’s cheapest

StateMedian cash
Nevada$1,990
Nebraska$2,304
Michigan$2,642
Arkansas$2,699
Montana$2,765
New Mexico$3,859

Prices by city

Prices by state

Doctors who perform this

Clinicians who reported the most Medicare volume for this service. This reflects Original Medicare activity only and is a volume signal, not a quality ranking.

ClinicianSpecialtyLocationMedicare services
Scott Newbrough, MDPlastic and Reconstructive SurgeryTulsa, OK19
Peter Ashjian, MDPlastic and Reconstructive SurgeryGlendale, CA18
Rimma Finkel, MDPlastic and Reconstructive SurgeryChandler, AZ17
John Apostolides, M.D.Plastic and Reconstructive SurgerySan Diego, CA16
Bret Johnson, M.D.Plastic and Reconstructive SurgeryDallas, TX16
Jerette Schultz, M.D.Plastic and Reconstructive SurgerySarasota, FL15
Tara Huston, MDPlastic and Reconstructive SurgeryStony Brook, NY13
Suhail Kanchwala, MDPlastic and Reconstructive SurgeryPhiladelphia, PA13
Nolan Karp, M.D.Plastic and Reconstructive SurgeryNew York, NY12
Robert Oliver, M.D.Plastic and Reconstructive SurgeryBirmingham, AL12
Andrew Hayduke, M.D.Plastic and Reconstructive SurgeryRancho Mirage, CA12
Luke Cusimano, M.D.Plastic and Reconstructive SurgeryBaton Rouge, LA12

Browse doctors by specialty & city →

Does Medicare cover Breast reconstruction?

Yes — Medicare generally covers Breast reconstruction. It is typically an inpatient service, so Medicare Part A (hospital insurance) pays the hospital a bundled rate — Medicare’s benchmark payment is about $1,227. Your own cost is mainly the Part A hospital deductible for the benefit period (a flat amount, not a percentage), plus any physician (Part B) charges. A Medicare Advantage or Medigap plan can change what you owe.

General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.

About these prices

Based on prices published by 1264 US hospitals across 51 states, the typical (median) cash price is $8,440, versus a chargemaster (list) price around $11,717, a median insurer-negotiated rate of $9,729, a Medicare rate of about $1,227. Most cash prices fall between $2,127 and $29,143 — a wide spread, which is exactly why comparing hospitals pays off.

How to save

  • Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
  • Compare several nearby hospitals; prices for the same service can differ severalfold.
  • Request a written estimate and the billing code (CPT/DRG) before scheduling.
  • Use the Medicare benchmark above to judge whether a quote is reasonable.
  • If you are uninsured, ask about financial assistance or prompt-pay discounts.

Frequently asked questions

How much does Breast reconstruction cost without insurance?
The median cash (self-pay) price across 1264 US hospitals is $8,440. Most hospitals fall between $2,127 and $29,143. Prices vary widely between hospitals, so it pays to compare before you book.
Does Medicare cover Breast reconstruction?
Yes — it is generally covered under Medicare Part A as an inpatient service (Medicare's benchmark payment is about $1,227). You pay the Part A hospital deductible for the benefit period, plus any Part B physician charges.
What does Medicare pay for Breast reconstruction?
Medicare pays about $1,227. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Breast reconstruction prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

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