go back

Custom Mould For A Made-To-Measure Breast Implant

Michigan 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?

$240

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $229 from a physician practice, and about $4,074 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$229$155 to $295
FacilityA hospital or hospital-owned outpatient department$4,074$4,074 to $4,898

How much rates vary

Facilitymedian $4,074 · 10th to 90th $316 to $6,918Professionalmedian $229 · 10th to 90th $123 to $316
$100$200$500$1K$2K$5K$10Kfacility $4,074professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$4,073.80
Typical High
$5,754.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$169.82
Typical High
$316.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$295.12
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$263.03
Typical High
$501.19
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$4,073.80
Typical High
$5,754.40
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$288.40
Typical High
$389.05
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
United
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$6,456.54
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$239.88
Typical High
$398.11

Where Michigan 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.

Michigan· 43rd of 51

$240

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.