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Indiana rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $11,220 · 10th–90th $1,047–$19,4980%10%10th90th$11,220Professionalmedian $229 · 10th–90th $120–$3980%10%10th90th$229$100.0$500.0$2.0K$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
$199.53 / $4,897.79 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $229.09 / $416.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $14,791.08 / $19,498.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $239.88 / $389.05
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $141.25 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $229.09 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $251.19 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $7,762.47 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $223.87 / $416.87