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Custom Mould For A Made-To-Measure Breast Implant

Maryland 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.

Facilitymedian $2,239 · 10th–90th $1,622$7,9430%20%10th90th$2,239Professionalmedian $229 · 10th–90th $123$4680%10%10th90th$229$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$229.09
Typical High
$416.87
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$141.25
Typical High
$162.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,621.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$281.84
Typical High
$575.44
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$354.81
Typical High
$537.03
United
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$2,238.72
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$234.42
Typical High
$478.63
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$398.11
Typical High
$446.68