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Illinois rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $2,570 · 10th–90th $275–$9,3330%5%10th90th$2,570Professionalmedian $245 · 10th–90th $123–$4790%10%10th90th$245$50.0$200.0$1.0K$5.0K$20.0K

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
$275.42 / $2,290.87 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $229.09 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $5,011.87 / $6,760.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $281.84 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $11,220.18 / $14,125.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $288.40 / $501.19
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $380.19 / $1,023.29
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $181.97 / $363.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $4,365.16 / $9,332.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $269.15 / $501.19