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Custom Mould For A Made-To-Measure Breast Implant

Massachusetts 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?

$302

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $302 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $2,089 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 8 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$288$155 to $417
FacilityA hospital or hospital-owned outpatient department$2,089$200 to $3,715

How much rates vary

Facilitymedian $2,089 · 10th to 90th $166 to $5,623Professionalmedian $288 · 10th to 90th $123 to $741
$100$200$500$1K$2K$5K$10Kfacility $2,089professional $288

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
$229.09
Median
$3,090.30
Typical High
$4,897.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$229.09
Typical High
$630.96
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$4,570.88
Typical High
$9,120.11
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$323.59
Typical High
$831.76
BCBS
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$389.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$389.05
Typical High
$776.25
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$186.21
Typical High
$3,630.78
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$416.87
Typical High
$524.81
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$5,248.07
Typical High
$11,220.18
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$331.13
Typical High
$758.58
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$4,570.88
Typical High
$9,120.11
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$323.59
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$5,248.07
Typical High
$11,220.18
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$354.81
Typical High
$776.25

Where Massachusetts 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.

Massachusetts· 19th of 51

$302

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.