search again

Custom Mould For A Made-To-Measure Breast Implant

Nationwide rates for HCPCS 19396

An impression of the chest is taken and shaped so that a breast implant can be manufactured to match the individual's own contour. It is the preparatory step used when a standard, off-the-shelf implant would not fit the chest wall well, and the finished implant is placed inside the body at a later operation.

Rates data updated July 2026.

Facilitymedian $4,898 · 10th–90th $263$12,5890%5%10%10th90th$4,898Professionalmedian $251 · 10th–90th $123$6760%10%10th90th$251$1.0$10.0$100.0$1.0K$10.0K$100.0K$1.0M

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
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$3,715.35
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$229.09
Typical High
$562.34
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$7,413.10
Typical High
$15,848.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$257.04
Typical High
$537.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$851.14
Typical High
$3,630.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$309.03
Typical High
$691.83
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$5,370.32
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$251.19
Typical High
$549.54