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Michigan rates for HCPCS C1789

Prosthesis, breast (implantable)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $2,754.23 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,047.13
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $2,754.23 / $6,165.95
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $2,630.27
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,047.13