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Minnesota rates for HCPCS 19396

Preparation Moulage Custom Breast Implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.72 / $271.81 / $4,828.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.72 / $271.81 / $413.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,445.23 / $6,669.88 / $14,092.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.89 / $486.62 / $929.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.34 / $959.13 / $2,307.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.05 / $596.29 / $1,142.35
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.80 / $876.88 / $1,816.79
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.82 / $550.40 / $992.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.93 / $319.61 / $5,499.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$381.11 / $803.71 / $1,186.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,293.00 / $6,652.00 / $9,810.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.71 / $738.51 / $1,162.88