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Custom Mould For A Made-To-Measure Breast Implant

Illinois 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?

$275

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $275 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $1,862 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$240$166 to $407
FacilityA hospital or hospital-owned outpatient department$1,862$708 to $5,012

How much rates vary

Facilitymedian $1,862 · 10th to 90th $251 to $7,943Professionalmedian $240 · 10th to 90th $123 to $525
$100$500$2K$10Kfacility $1,862professional $240

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
$251.19
Median
$1,659.59
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$229.09
Typical High
$537.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$5,011.87
Typical High
$6,760.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$281.84
Typical High
$501.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5,370.32
Median
$11,220.18
Typical High
$14,125.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$288.40
Typical High
$501.19
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$380.19
Typical High
$1,023.29
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$181.97
Typical High
$363.08
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$4,365.16
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$269.15
Typical High
$512.86

Where Illinois 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.

Illinois· 27th of 51

$275

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.