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West Virginia rates for HCPCS C1789

Prosthesis, breast (implantable)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,298.30 / $6,262.52 / $17,050.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.32 / $402.32 / $402.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.42 / $104.42 / $104.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.93 / $1,054.93 / $1,353.81
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,839.75 / $2,053.23 / $12,458.38