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Kentucky rates for HCPCS 19396

Preparation of moulage for custom breast implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.57 / $397.08 / $8,229.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.57 / $222.96 / $253.36
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,830.00 / $8,584.00 / $11,253.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.39 / $196.51 / $340.91
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.97 / $183.89 / $212.14
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.05 / $183.89 / $262.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.35 / $241.68 / $241.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.11 / $253.52 / $510.61
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$739.00 / $3,828.00 / $8,582.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.08 / $275.20 / $522.55