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Massachusetts rates for HCPCS 19396

Preparation Moulage Custom Breast Implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.46 / $2,663.12 / $4,410.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.11 / $219.19 / $372.95
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$345.74 / $4,402.00 / $7,608.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.91 / $420.43 / $2,124.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.91 / $216.98 / $421.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.62 / $459.65 / $898.44
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.49 / $300.00 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.43 / $392.27 / $576.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.95 / $391.04 / $733.85
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$709.79 / $5,268.00 / $9,401.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.88 / $713.69 / $2,124.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $4,983.00 / $8,810.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.36 / $507.31 / $946.35