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Custom Mould For A Made-To-Measure Breast Implant

Nebraska 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?

$447

Typical negotiated rate. In Nebraska, July 2026.

Insurers have agreed to pay about $447 for this service. The price depends on where it is billed: about $316 from a physician practice, and about $7,413 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$316$251 to $589
FacilityA hospital or hospital-owned outpatient department$7,413$4,898 to $10,000

How much rates vary

Facilitymedian $7,413 · 10th to 90th $479 to $14,454Professionalmedian $316 · 10th to 90th $129 to $1,514
$200$500$1K$2K$5K$10K$20Kfacility $7,413professional $316

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
$5,754.40
Median
$8,511.38
Typical High
$14,454.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$251.19
Typical High
$1,548.82
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$3,162.28
Typical High
$6,165.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$263.03
Typical High
$524.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$501.19
Typical High
$794.33
Medica
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$380.19
Typical High
$6,309.57
Medica
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$575.44
Typical High
$2,041.74
Midlands
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$588.84
Typical High
$831.76
Midlands
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$5,128.61
Typical High
$7,585.78
United
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$338.84
Typical High
$660.69

Where Nebraska 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.

Nebraska· 6th of 51

$447

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.