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Nationwide rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $4,786 · 10th–90th $288–$12,3030%10%20%10th90th$4,786Professionalmedian $240 · 10th–90th $123–$5500%20%10th90th$240$0.1$2.0$50.0$1.0K$20.0K$500.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $4,073.80 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $229.09 / $416.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $7,413.10 / $15,848.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $263.03 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $954.99 / $7,413.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $309.03 / $676.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $5,370.32 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $251.19 / $537.03

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