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New Jersey rates for HCPCS C1789

Prosthesis, breast (implantable)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$874.95 / $2,070.48 / $3,559.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.88 / $402.32 / $3,306.43
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,019.44 / $35,947.73 / $57,980.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.93 / $1,054.93 / $1,054.93