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Implantable Breast Prosthesis

Utah rates for HCPCS C1789

Prosthesis, breast (implantable)

Rates data updated July 2026.

Facilitymedian $3,020 · 10th–90th $617$3,8900%20%10th90th$3,020Professionalmedian $398 · 10th–90th $398$3980%50%$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
$616.60
Median
$3,019.95
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$44.67
Select Health
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
Select Health
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$5,011.87
Typical High
$5,011.87