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Alaska rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $380 · 10th–90th $166–$9,7720%5%10%10th90th$380Professionalmedian $269 · 10th–90th $123–$9550%5%10%10th90th$269$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$758.58 / $10,715.19 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $234.42 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $346.74 / $478.63
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $371.54 / $1,258.93
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $724.44 / $1,737.80
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,096.48 / $1,479.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $338.84 / $1,258.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $316.23 / $602.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $7,943.28 / $7,943.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $630.96 / $1,659.59