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Washington, DC rates for HCPCS 19396

Preparation Moulage Custom Breast Implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.64 / $3,999.00 / $6,456.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.47 / $143.47 / $288.64
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.68 / $141.35 / $2,500.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.15 / $274.24 / $778.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.38 / $638.47 / $638.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,648.00 / $3,378.00 / $26,408.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.04 / $405.20 / $737.81