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Custom Mould For A Made-To-Measure Breast Implant

Louisiana 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?

$339

Typical negotiated rate. In Louisiana, July 2026.

Insurers have agreed to pay about $339 for this service. The price depends on where it is billed: about $245 from a physician practice, and about $2,570 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$245$166 to $316
FacilityA hospital or hospital-owned outpatient department$2,570$1,096 to $4,169

How much rates vary

Facilitymedian $2,570 · 10th to 90th $447 to $6,607Professionalmedian $245 · 10th to 90th $135 to $363
$200$500$1K$2K$5K$10Kfacility $2,570professional $245

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
$309.03
Median
$1,905.46
Typical High
$4,570.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$218.78
Typical High
$363.08
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$6,025.60
Typical High
$9,120.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$251.19
Typical High
$316.23
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$263.03
Typical High
$467.74
United
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$3,715.35
Typical High
$8,912.51
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$239.88
Typical High
$446.68

Where Louisiana 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.

Louisiana· 15th of 51

$339

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.