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Maine rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $7,943 · 10th–90th $7,943–$7,9430%50%100%$7,943Professionalmedian $240 · 10th–90th $126–$4790%5%10%10th90th$240$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $229.09 / $416.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $269.15 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $316.23 / $602.56
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $323.59 / $549.54
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $218.78 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $7,943.28 / $7,943.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $331.13 / $562.34