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
IMPL BRST SPECT 225ML SMTH RND EXPANDER
Troy, NY
See all hospitals reporting HCPCS C1789 →Price type
Samaritan Hospital’s median price of $1.2k is 42% below the median hospital's median price ($2.1k), higher than 23% 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: 15 payers, 26 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 aetna facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 2 | Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 3 | Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 4 | Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 5 | Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 6 | Cigna cigna facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 7 | Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 8 | Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 9 | Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 10 | Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 11 | Medical Mutual aetna facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 12 | Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 13 | Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 14 | UnitedHealthcare uhc essential plan medicaid facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 15 | UnitedHealthcare united healthcare medicaid harp chip facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 16 | Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 17 | Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $1,163 | $1,211 | $5.00 – $2,180 |
| 18 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $2,159 | $2,346 | $6.88 – $5,450 |
| 19 | First Health first health facility · percent of total billed charges · bothfrom % of charges | $2,325 | $2,422 | $10.00 – $4,360 |
| 20 | MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges | $2,616 | $2,724 | $11.25 – $4,905 |
| 21 | MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges | $2,616 | $2,724 | $11.25 – $4,905 |
| 22 | Phcs multiplan facility · percent of total billed charges · bothfrom % of charges | $2,616 | $2,724 | $11.25 – $4,905 |
| 23 | Anthem empire medicaid facility · percent of total billed charges · bothfrom % of charges | $2,906 | $3,027 | $12.50 – $5,450 |
| 24 | Anthem empire medicaid essential 1 2 3 4 facility · percent of total billed charges · bothfrom % of charges | $2,906 | $3,027 | $12.50 – $5,450 |
| 25 | Excellus empire medicaid facility · percent of total billed charges · bothfrom % of charges | $2,906 | $3,027 | $12.50 – $5,450 |
Last updated: Mar 31, 2026
See Smooth low-profile rectangular tissue expander, 160-320 cc pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.