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Missouri rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $4,467 · 10th–90th $1,479–$15,1360%5%10th90th$4,467Professionalmedian $234 · 10th–90th $123–$4370%10%10th90th$234$100.0$500.0$2.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $4,265.80 / $15,135.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $229.09 / $416.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $5,011.87 / $16,218.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $223.87 / $407.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $263.03 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $13,803.84 / $15,848.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $281.84 / $562.34
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $416.87 / $5,888.44
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $416.87 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,090.30 / $5,370.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $239.88 / $416.87