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Kansas rates for HCPCS 19396

Preparation of moulage for custom breast implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,700.00 / $4,919.00 / $12,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.95 / $234.50 / $369.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.68 / $242.68 / $473.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,517.00 / $12,517.00 / $12,517.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.54 / $299.04 / $511.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.37 / $269.93 / $5,897.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.37 / $422.04 / $2,056.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,779.00 / $3,647.00 / $6,988.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.37 / $299.81 / $544.20