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Custom Mould For A Made-To-Measure Breast Implant

North Dakota 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?

$316

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $316 for this service. The price depends on where it is billed: about $331 from a physician practice, and about $269 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 5 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$331$275 to $537
FacilityA hospital or hospital-owned outpatient department$269$145 to $288

How much rates vary

Facilitymedian $269 · 10th to 90th $135 to $5,888Professionalmedian $331 · 10th to 90th $145 to $631
$200$500$1K$2K$5Kfacility $269professional $331

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
$5,011.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$269.15
Typical High
$288.40
BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$398.11
Typical High
$660.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$354.81
Typical High
$831.76
Medica
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$288.40
Typical High
$489.78
Medica
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$524.81
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$5,370.32
Median
$5,888.44
Typical High
$5,888.44
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$316.23
Typical High
$660.69

Where North Dakota 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 Dakota· 18th of 51

$316

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.