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Arizona rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $3,548 · 10th–90th $457–$7,7620%5%10%10th90th$3,548Professionalmedian $229 · 10th–90th $120–$5010%10%10th90th$229$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
$2,089.30 / $3,890.45 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $229.09 / $501.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $1,778.28 / $3,388.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $218.78 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $234.42 / $446.68
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $269.15 / $5,754.40
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $338.84 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,890.45 / $7,244.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $218.78 / $407.38