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Implantable Breast Prosthesis

Pennsylvania rates for HCPCS C1789

Prosthesis, breast (implantable)

Rates data updated October 2026.

How much does Implantable Breast Prosthesis cost?

$398

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $398 for this service. The price depends on where it is billed: about $398 from a physician practice, and about $2,570 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$398$398 to $955
FacilityA hospital or hospital-owned outpatient department$2,570$741 to $4,467

How much rates vary

Facilitymedian $2,570 · 10th to 90th $398 to $31,623Professionalmedian $398 · 10th to 90th $398 to $955
$500$1K$2K$5K$10K$20K$50Kfacility $2,570professional $398

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$1,445.44
Aetna
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$81.28
Median
$81.28
Typical High
$81.28
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
AmeriHealth
Setting
Facility
Modifier
None
Typical Low
$25,118.86
Median
$39,810.72
Typical High
$69,183.10
Cigna
Setting
Professional
Modifier
None
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$776.25
Median
$1,862.09
Typical High
$3,311.31
Independence Blue Cross
Setting
Facility
Modifier
None
Typical Low
$25,118.86
Median
$32,359.37
Typical High
$69,183.10
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$1,445.44
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$81.28
Median
$81.28
Typical High
$81.28
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$2,398.83
Median
$3,235.94
Typical High
$5,370.32

Where Pennsylvania sits

The same service costs 331.1 times more in Colorado than in Connecticut. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 28th of 51

$398

CO $3,311CT $10.00

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.