go back

Virginia rates for HCPCS C1789

Prosthesis, breast (implantable)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$402.32 / $3,397.26 / $8,508.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.32 / $402.32 / $1,912.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $11.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.93 / $1,054.93 / $1,054.93
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$402.32 / $402.32 / $612.73
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,291.00 / $1,291.00 / $4,071.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,291.00 / $1,291.00 / $4,071.00