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Hawaii rates for HCPCS C1789

Prosthesis, breast (implantable)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,166.36 / $7,166.36 / $7,166.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.88 / $292.88 / $292.88
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$668.00 / $699.48 / $699.48