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Custom Mould For A Made-To-Measure Breast Implant

Maine 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?

$245

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $245 for this service. Most negotiated rates run $182 to $380.

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 $7,943 · 10th to 90th $7,943 to $7,943Professionalmedian $245 · 10th to 90th $138 to $513
$200$500$1K$2K$5Kfacility $7,943professional $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. 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
$114.82
Median
$144.54
Typical High
$229.09
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$269.15
Typical High
$478.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$316.23
Typical High
$602.56
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$323.59
Typical High
$562.34
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$144.54
Typical High
$229.09
United
Setting
Facility
Modifier
Global
Typical Low
$7,943.28
Median
$7,943.28
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$331.13
Typical High
$588.84

Where Maine 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.

Maine· 42nd of 51

$245

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.