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Michigan rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $4,074 · 10th–90th $316–$6,3100%20%10th90th$4,074Professionalmedian $229 · 10th–90th $120–$3800%10%10th90th$229$50.0$200.0$1.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $4,073.80 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $223.87 / $380.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $213.80 / $213.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $213.80 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $263.03 / $501.19
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $4,073.80 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $302.00 / $436.52
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $239.88 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $6,309.57 / $10,471.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $239.88 / $389.05