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Custom Mould For A Made-To-Measure Breast Implant

Alabama 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 $2,188 · 10th–90th $871$4,5710%10%10th90th$2,188Professionalmedian $224 · 10th–90th $123$3390%20%10th90th$224$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
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$1,230.27
Typical High
$2,398.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$223.87
Typical High
$295.12
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$2,290.87
Typical High
$3,090.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$199.53
Typical High
$323.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$245.47
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$3,467.37
Typical High
$5,370.32
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$208.93
Typical High
$354.81