Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
1221303 - IMPLANT BRST 255 CC P3.8 CM MODERATE PRFL RND SMTH COHESIVE
Chicago, IL
See all hospitals reporting HCPCS C1789 →Price type
Advocate Illinois Masonic Medical Center’s median price of $2.6k is 27% above the median hospital's median price ($2.1k), higher than 65% of the 1,315 hospitals reporting HCPCS C1789. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 12 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Blue Cross Blue Shield commercial percent of total billed charges · outpatientfrom % of charges | $1,306 | $1,229 | $824.12 – $1,467 |
| 2 | Blue Cross Blue Shield managed care percent of total billed charges · outpatientfrom % of charges | $1,319 | $1,273 | $889.47 – $1,461 |
| 3 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $1,395 | $1,346 | $940.30 – $1,544 |
| 4 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $1,583 | $1,528 | $1,067 – $1,753 |
| 5 | UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges | $2,164 | $2,337 | $1,267 – $3,554 |
| 6 | Cigna commercial percent of total billed charges · inpatientfrom % of charges | $2,761 | $2,651 | $1,815 – $3,101 |
| 7 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $2,761 | $2,651 | $1,815 – $3,101 |
| 8 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $2,852 | $2,753 | $1,923 – $3,158 |
| 9 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $2,852 | $2,753 | $1,923 – $3,158 |
| 10 | UnitedHealthcare hmo percent of total billed charges · outpatientfrom % of charges | $3,715 | $3,586 | $2,505 – $4,114 |
| 11 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $4,307 | $4,158 | $2,904 – $4,770 |
| 12 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $4,307 | $4,158 | $2,904 – $4,770 |
Last updated: Nov 4, 2025
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