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Illinois rates for HCPCS C1789

Prosthesis, breast (implantable)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $3,548.13 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,047.13
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $199.53 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00