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Hawaii rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $4,467 · 10th–90th $1,778–$4,4670%50%10th$4,467Professionalmedian $229 · 10th–90th $120–$4070%10%10th90th$229$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,778.28 / $4,466.84 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $223.87 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $275.42 / $354.81
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $295.12 / $4,570.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $316.23 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $245.47 / $398.11
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $165.96 / $346.74