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Custom Mould For A Made-To-Measure Breast Implant

Washington, DC 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.

How much does Custom Mould For A Made-To-Measure Breast Implant cost?

$288

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $288 for this service. Most negotiated rates run $145 to $646.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $4,074 · 10th to 90th $145 to $7,762Professionalmedian $275 · 10th to 90th $141 to $331
$100$500$2K$10Kfacility $4,074professional $275

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$3,981.07
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$162.18
Typical High
$288.40
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$630.96
Typical High
$8,128.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$269.15
Typical High
$776.25
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$331.13
Typical High
$645.65
United
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$10,000.00
Typical High
$27,542.29
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$323.59
Typical High
$660.69

Where Washington, DC sits

The same service costs 21.4 times more in California than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington, DC· 25th of 51

$288

CA $4,571WV $214

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.