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
1225240 - IMPLANT BRST 330 CC P4.1 CM MODERATE PRFL RND SMTH SHELL
Summit, WI
See all hospitals reporting HCPCS C1789 →Price type
Aurora Medical Center Summit’s median price of $2.1k is 4% above the median hospital's median price ($2.1k), higher than 52% 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: 6 payers, 21 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 | Aetna hmo percent of total billed charges · outpatientfrom % of charges | $1,735 | $1,581 | $1,172 – $1,882 |
| 2 | UnitedHealthcare charter percent of total billed charges · outpatientfrom % of charges | $2,120 | $1,932 | $1,432 – $2,300 |
| 3 | UnitedHealthcare exchange percent of total billed charges · outpatientfrom % of charges | $2,120 | $1,932 | $1,432 – $2,300 |
| 4 | UnitedHealthcare hmo percent of total billed charges · outpatientfrom % of charges | $2,120 | $1,932 | $1,432 – $2,300 |
| 5 | UnitedHealthcare nexus percent of total billed charges · outpatientfrom % of charges | $2,120 | $1,932 | $1,432 – $2,300 |
| 6 | Anthem blue priority percent of total billed charges · outpatientfrom % of charges | $2,142 | $1,951 | $1,447 – $2,323 |
| 7 | Healthpartners employee trust fund percent of total billed charges · outpatientfrom % of charges | $2,142 | $1,951 | $1,447 – $2,323 |
| 8 | Molina commercial percent of total billed charges · outpatientfrom % of charges | $2,142 | $1,951 | $1,447 – $2,323 |
| 9 | Anthem blue preferred percent of total billed charges · outpatientfrom % of charges | $2,320 | $2,114 | $1,567 – $2,517 |
| 10 | Cigna ppo-gppo percent of total billed charges · outpatientfrom % of charges | $2,677 | $2,439 | $1,808 – $2,904 |
| 11 | Healthpartners broad percent of total billed charges · inpatientfrom % of charges | $2,677 | $2,439 | $1,808 – $2,904 |
| 12 | Healthpartners broad percent of total billed charges · outpatientfrom % of charges | $2,677 | $2,439 | $1,808 – $2,904 |
| 13 | Healthpartners robin percent of total billed charges · outpatientfrom % of charges | $2,677 | $2,439 | $1,808 – $2,904 |
| 14 | Aetna ppo percent of total billed charges · inpatientfrom % of charges | $2,948 | $2,686 | $1,992 – $3,198 |
| 15 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $2,948 | $2,686 | $1,992 – $3,198 |
| 16 | UnitedHealthcare ppo percent of total billed charges · inpatientfrom % of charges | $3,005 | $2,738 | $2,030 – $3,260 |
| 17 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $3,005 | $2,738 | $2,030 – $3,260 |
| 18 | Cigna ppo percent of total billed charges · inpatientfrom % of charges | $3,020 | $2,751 | $2,040 – $3,276 |
| 19 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $3,020 | $2,751 | $2,040 – $3,276 |
| 20 | Anthem ppo percent of total billed charges · inpatientfrom % of charges | $3,034 | $2,764 | $2,050 – $3,291 |
| 21 | Anthem ppo percent of total billed charges · outpatientfrom % of charges | $3,034 | $2,764 | $2,050 – $3,291 |
Last updated: Nov 21, 2025
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