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Implantable Breast Prosthesis

South Carolina rates for HCPCS C1789

Prosthesis, breast (implantable)

Rates data updated July 2026.

Facilitymedian $4,169 · 10th–90th $447$6,3100%10%10th90th$4,169Professionalmedian $398 · 10th–90th $398$2,2910%50%90th$398$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,412.54
Median
$4,168.69
Typical High
$6,309.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$2,290.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Medcost
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$426.58
Typical High
$794.33
Medcost
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20