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Iowa rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $3,981 · 10th–90th $331–$8,9130%5%10th90th$3,981Professionalmedian $251 · 10th–90th $129–$6760%5%10%10th90th$251$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
$213.80 / $3,801.89 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $245.47 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $407.38 / $741.31
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $338.84 / $1,096.48
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $691.83 / $9,772.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $478.63 / $1,174.90
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $549.54 / $741.31
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $436.52 / $776.25
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $645.65 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $7,762.47 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $309.03 / $645.65
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $302.00 / $562.34