Level 4 Breast/lymphatic Surgery and Related Procedures — what U.S. hospitals charge
APC 5094 · Hospital outpatient visit · 47 U.S. hospitals publish a price
Cheapest quarter
under $69,628
Typical charge
$95,806
Dearest quarter
over $122,388
Actually paid
$16,931
The middle U.S. hospital bills $95,806 for Level 4 Breast/lymphatic Surgery and Related Procedures. The dearest hospitals charge about 3.0x what the cheapest do for the same coded work. Medicare actually paid about $16,931 per case.
These are charges, not quotes. What you pay depends on your insurance and your own case. The figures matter because the charge is where an uninsured or out-of-network bill starts.
Level 4 Breast/lymphatic Surgery and Related Procedures cost by state
The middle charge in each state where at least three hospitals publish a price, cheapest first.
| State | Hospitals | Typical charge | Range |
|---|---|---|---|
| New York | 5 | $69,593 | $56,396 – $169,336 |
| Minnesota | 3 | $79,689 | $44,809 – $88,213 |
| Texas | 5 | $94,294 | $58,339 – $130,615 |
| New Jersey | 3 | $123,985 | $45,631 – $133,379 |
| Florida | 7 | $130,438 | $69,663 – $236,254 |
| California | 3 | $198,575 | $112,893 – $264,517 |
Where Level 4 Breast/lymphatic Surgery and Related Procedures is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Cox Medical Centers
Springfield, MO |
$42,809 | $13,594 |
|
Park Nicollet Methodist Hospital
Saint Louis Park, MN |
$44,809 | $16,809 |
|
Cooper University Hospital
Camden, NJ |
$45,631 | $18,406 |
|
University Of Michigan Health System
Ann Arbor, MI |
$50,734 | $16,268 |
|
Memorial Hospital For Cancer And Allied Diseases
New York, NY |
$56,396 | $20,004 |
|
University Of Texas M D Anderson Cancer Center
Houston, TX |
$58,339 | $15,817 |
|
Womans Hospital
Baton Rouge, LA |
$62,474 | $14,872 |
|
Brigham And Women Faulkner Hospital
Jamaica Plain, MA |
$64,361 | $18,881 |
|
Northshore University Healthsystem - Evanston Hospital
Evanston, IL |
$64,826 | $16,359 |
|
New York-Presbyterian Hospital
New York, NY |
$65,109 | $20,003 |
|
Community Hospital
Munster, IN |
$66,459 | $14,054 |
|
Suny/Stony Brook University Hospital
Stony Brook, NY |
$69,593 | $19,634 |
Where it is charged most
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Cedars-Sinai Medical Center
Los Angeles, CA |
$264,517 | $21,610 |
|
Orlando Health
Orlando, FL |
$236,254 | $15,930 |
|
Scripps Memorial Hospital La Jolla
La Jolla, CA |
$198,575 | $21,610 |
|
Honorhealth Scottsdale Shea Medical Center
Scottsdale, AZ |
$183,850 | $15,953 |
|
Jupiter Medical Center
Jupiter, FL |
$172,471 | $15,930 |
|
Nyu Langone Hospitals
New York, NY |
$169,336 | $19,793 |
|
Norton Hospitals, Inc
Louisville, KY |
$151,920 | $14,052 |
|
Adventhealth Orlando
Orlando, FL |
$141,084 | $15,930 |
|
Riverview Medical Center
Red Bank, NJ |
$133,379 | $18,636 |
|
Baylor Scott & White Medical Center Plano
Plano, TX |
$130,615 | $15,826 |
|
Sarasota Memorial Hospital
Sarasota, FL |
$130,438 | $15,930 |
|
Overlook Medical Center
Summit, NJ |
$123,985 | $19,783 |
Questions people ask
What do U.S. hospitals charge for Level 4 Breast/lymphatic Surgery and Related Procedures?
Across 47 U.S. hospitals, the middle charge for Level 4 Breast/lymphatic Surgery and Related Procedures is $95,806. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $69,628 and the dearest quarter over $122,388.
Why do hospitals charge such different amounts for the same procedure?
Because a hospital charge is a list price it sets itself, not a regulated rate. For Level 4 Breast/lymphatic Surgery and Related Procedures, the hospitals in the dearest tenth charge about 3.0x what the cheapest tenth charge for the same coded work. Insurers negotiate their own rates from those lists, which is why the charge and what is actually paid can be very far apart.
Is that what I would actually pay?
No. $16,931 is roughly what Medicare actually paid per case, against an average charge of $100,681. If you have insurance, your plan pays a negotiated rate and you pay your deductible and coinsurance. If you are uninsured or out of network, the hospital's charge is where your bill starts — which is why the gap matters. Ask for a written good-faith estimate before treatment.
What this code covers
CMS records this work as APC 5094: “Level 4 Breast/Lymphatic Surgery and Related Procedures”. An APC covers one outpatient visit for that level of service — you go home the same day.