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North Carolina rates for HCPCS C1789

Prothesis, breast (implantable)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,738.91 / $5,553.46 / $9,828.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.32 / $402.32 / $402.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.93 / $1,054.93 / $1,054.93
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$402.32 / $402.32 / $482.78
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$840.00 / $840.00 / $840.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $1,874.50