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Custom Mould For A Made-To-Measure Breast Implant

Kansas 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 Kansas, 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 $3,631 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 5 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$170 to $372
FacilityA hospital or hospital-owned outpatient department$3,631$2,089 to $6,457

How much rates vary

Facilitymedian $3,631 · 10th to 90th $257 to $9,550Professionalmedian $240 · 10th to 90th $126 to $468
$100$200$500$1K$2K$5K$10Kfacility $3,631professional $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
$288.40
Median
$3,801.89
Typical High
$10,471.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$199.53
Typical High
$389.05
BCBS
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$12,589.25
Median
$12,589.25
Typical High
$12,589.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$288.40
Typical High
$501.19
Medica
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$323.59
Typical High
$5,888.44
Medica
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$354.81
Typical High
$2,041.74
United
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$2,951.21
Typical High
$6,456.54
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$229.09
Typical High
$426.58

Where Kansas 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.

Kansas· 28th 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.