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Cost of 1st stage breast reconstruction in Massachusetts

The average cash price for 1st stage breast reconstruction care in Massachusetts is $11,822 at a surgery center versus $23,593 at an outpatient hospital. While an outpatient hospital may offer more complimentary and support services for patients, it costs almost twice as much (50%) when comparing 1st stage breast reconstruction procedures performed at a surgery center. Read More

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Average cash price in Massachusetts

A common 1st stage breast reconstruction at surgery center facility in Massachusetts includes

  Units Avg Cash price

Provider

Plastic & reconstructive surgeon visit provider fee

First time visit Standard
1 $141

Provider fee for breast reconstruction

Standard Standard
1 $2,336

Facility

Surgery center fee for breast reconstruction

Standard Standard
1 $8,071

Imaging

Radiology fee for x-ray of breast or mammogram of both breasts

Standard Standard
1 $236

Prescriptions

HYDROCODONE-ACETAMINOPHEN

Standard Standard
30 $18

Anesthesia

Anesthesiologist fee to be "put under" for procedure

Level 3 Standard
1 $231

Anesthesiologist time to be "put under" for procedure

Per minute Standard
344 $788
Total average cash price   $11,821.79

A common 1st stage breast reconstruction at outpatient hospital facility in Massachusetts includes

  Units Avg Cash price

Provider

Plastic & reconstructive surgeon visit provider fee

First time visit Standard
1 $141

Provider fee for breast reconstruction

Standard Standard
1 $2,336

Facility

Outpatient Hospital fee for breast reconstruction

level 4 Standard
1 $19,842

Imaging

Radiology fee for x-ray of breast or mammogram of both breasts

Standard Standard
1 $236

Prescriptions

HYDROCODONE-ACETAMINOPHEN

Standard Standard
30 $18

Anesthesia

Anesthesiologist fee to be "put under" for procedure

Level 3 Standard
1 $231

Anesthesiologist time to be "put under" for procedure

Per minute Standard
344 $788
Total average cash price   $23,592.59

The staged approach to breast reconstruction involves some reconstructive surgery during the mastectomy or lumpectomy and more reconstructive surgery after any additional radiation or chemotherapy treatments. The first stage involves placing a tissue expander that preserves the shape of the breast until radiation or chemotherapy has been completed and the tissues have recovered (usually 4-6 months). In stage two, the tissue expander is removed and replaced with a permanent breast implant. 

Immediately following a mastectomy, the surgeon will create a pouch under the chest muscle. Next, a tissue expander made of silicone is placed in the pouch. The chest remains flat, but after two to three weeks, the surgeon will inject a small amount of saline through a valve into the expander. The surgeon will continue to do this every one to two weeks until the expander slowly enlarges the pouch to the correct size to place the implant. After the allotted time, the permanent breast implant is placed.  

One-stage breast reconstruction is only an option for breast cancer patients who don’t require additional treatments, such as chemotherapy or radiation therapy, after mastectomy. This is because radiation therapy and chemotherapy given after surgery can cause a reconstructed breast to lose volume and change color, texture, and appearance. In one-stage breast reconstruction, a breast cancer surgeon removes the breast, and then a plastic surgeon either reconstructs the breast with tissue from another part of the body or inserts a breast implant. The major advantage of this approach is it only requires one major surgery. Additionally, a woman wakes up from her mastectomy with breasts. 

It takes about 6 to 8 weeks to recover physically after breast reconstruction surgery. After that, most women can start getting back to normal activities. However, breast cancer survivors will often experience a myriad of emotions, and getting back to normal life may trigger those. Feeling anxiety, depression, or even post-traumatic stress is normal. It may be helpful to talk to a counselor or other women who have had breast cancer and breast reconstruction. They can help you walk through those emotions and how these changes to your body have affected you as a woman post-surgery. 

Numbness following mastectomy and reconstruction surgery is common. During surgery, nerves that supply feeling to the chest are removed in addition to breast tissue, and although some sensation can return, the numbness is usually permanent. Restoring sensation has not been a focus of breast reconstructive surgery until recently. Fortunately, there are some newer techniques that are available that may help restore that sensation that may be worth discussing with the surgeon.

About the 1st stage breast reconstruction Average Cash Prices

This procedure is most commonly performed at either a surgery center or an outpatient hospital.

Surgery centers, also known as ambulatory surgery centers (ASCs), are independent, licensed medical facilities that are governed by distinct regulatory requirements compared with a hospital. Procedures performed at an ASCs are often less expensive than when they are performed at an outpatient hospital, but they typically offer fewer complimentary services, and may not have the full-range of support services that a hospital provides.

Outpatient facilities are outpatient departments or clinics that may be within or next to a hospital, but is owned and run by the affiliated hospital. These facilities can perform surgical treatments and procedures that do not require an overnight stay. Procedures performed at an outpatient hospital are often more expensive than when they are performed in an ambulatory surgery center, but outpatient hospitals may offer more complimentary and support services for patients because they are connected to the hospital system.

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* Savings estimate based on a study of more than 1 billion claims comparing self-pay (or cash pay) prices of a frequency-weighted market basket of procedures to insurer-negotiated rates for the same. Claims were collected between July 2017 and July 2019. R.Lawrence Van Horn, Arthur Laffer, Robert L.Metcalf. 2019. The Transformative Potential for Price Transparency in Healthcare: Benefits for Consumers and Providers. Health Management Policy and Innovation, Volume 4, Issue 3.

Sidecar Health offers and administers a variety of plans including ACA compliant and excepted benefit plans. Coverage and plan options may vary or may not be available in all states.

Your actual costs may be higher or lower than these cost estimates. Check with your provider and health plan details to confirm the costs that you may be charged for a service or procedure.You are responsible for costs that are not covered and for getting any pre-authorizations or referrals required by your health plan. Neither payments nor benefits are guaranteed. Provider data, including price data, provided in part by Turquoise Health.

The site is not a substitute for medical or healthcare advice and does not serve as a recommendation for a particular provider or type of medical or healthcare.