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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.

Rates data updated July 2026.

How much does Custom Mould For A Made-To-Measure Breast Implant cost?

$229

Typical physician fee. In Maryland, July 2026.

Insurers have agreed to pay about $229 for this service. Most negotiated rates run $141 to $288.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2,239 · 10th to 90th $1,622 to $7,943Professionalmedian $229 · 10th to 90th $123 to $759
$200$500$1K$2K$5Kfacility $2,239professional $229

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$229.09
Typical High
$758.58
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
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
$549.54
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
$134.90
Median
$239.88
Typical High
$489.78
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$398.11
Typical High
$446.68

Where Maryland 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.

Maryland· 47th of 51

$229

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.