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Custom Mould For A Made-To-Measure Breast Implant

Minnesota 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?

$490

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $490 for this service. The price depends on where it is billed: about $468 from a physician practice, and about $1,862 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$468$309 to $676
FacilityA hospital or hospital-owned outpatient department$1,862$759 to $6,026

How much rates vary

Facilitymedian $1,862 · 10th to 90th $269 to $11,482Professionalmedian $468 · 10th to 90th $224 to $955
$100$500$2K$10Kfacility $1,862professional $468

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
$134.90
Median
$269.15
Typical High
$269.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$416.87
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$8,511.38
Typical High
$17,378.01
BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$489.78
Typical High
$933.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$977.24
Typical High
$2,691.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$602.56
Typical High
$1,148.15
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,071.52
Typical High
$2,089.30
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$549.54
Typical High
$1,023.29
Medica
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$371.54
Typical High
$9,332.54
Medica
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$616.60
Typical High
$1,174.90
United
Setting
Facility
Modifier
Global
Typical Low
$3,311.31
Median
$6,456.54
Typical High
$10,715.19
United
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$457.09
Typical High
$933.25

Where Minnesota 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.

Minnesota· 5th of 51

$490

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.