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Implantable Breast Prosthesis

Pennsylvania rates for HCPCS C1789

Prosthesis, breast (implantable)

Rates data updated July 2026.

Facilitymedian $1,288 · 10th–90th $398$4,0740%5%10%10th90th$1,288Professionalmedian $398 · 10th–90th $398$9550%50%90th$398$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,258.93
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$512.86
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$25,703.96
Median
$52,480.75
Typical High
$69,183.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,778.28
Typical High
$3,311.31
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$25,703.96
Median
$39,810.72
Typical High
$69,183.10
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,258.93
Typical High
$4,786.30
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$512.86
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$3,548.13
Typical High
$5,623.41