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Custom Mould For A Made-To-Measure Breast Implant

North Carolina 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?

$269

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $269 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $447 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$269$162 to $355
FacilityA hospital or hospital-owned outpatient department$447$234 to $2,630

How much rates vary

Facilitymedian $447 · 10th to 90th $138 to $8,710Professionalmedian $269 · 10th to 90th $138 to $537
$200$500$1K$2K$5K$10Kfacility $447professional $269

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
$186.21
Median
$1,000.00
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$269.15
Typical High
$524.81
BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$281.84
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$288.40
Typical High
$575.44
Medcost
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$251.19
Typical High
$436.52
Medcost
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$8,912.51
Typical High
$16,982.44
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$229.09
Typical High
$524.81
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$8,912.51
Typical High
$8,912.51
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$2,137.96
Median
$2,137.96
Typical High
$2,290.87

Where North Carolina 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.

North Carolina· 30th of 51

$269

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.