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Custom Mould For A Made-To-Measure Breast Implant

New Mexico 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 October 2026.

How much does Custom Mould For A Made-To-Measure Breast Implant cost?

$275

Typical negotiated rate. In New Mexico, October 2026.

Insurers have agreed to pay about $275 for this service. The price depends on where it is billed: about $251 from a physician practice, and about $2,089 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$251$186 to $347
FacilityA hospital or hospital-owned outpatient department$2,089$794 to $3,236

How much rates vary

Facilitymedian $2,089 · 10th to 90th $316 to $7,762Professionalmedian $251 · 10th to 90th $123 to $468
$50$200$1K$5Kfacility $2,089professional $251

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$1,548.82
Typical High
$8,709.64
Aetna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$169.82
Typical High
$323.59
Cigna
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$1,862.09
Typical High
$2,570.40
Cigna
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$269.15
Typical High
$467.74
Molina
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$75.86
Typical High
$380.19
Providence
Setting
Facility
Modifier
None
Typical Low
$239.88
Median
$707.95
Typical High
$2,691.53
Providence
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$269.15
Typical High
$478.63
United
Setting
Facility
Modifier
None
Typical Low
$1,230.27
Median
$3,235.94
Typical High
$10,471.29
United
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$251.19
Typical High
$489.78

Where New Mexico sits

The same service costs 5.8 times more in Alaska than in Hawaii. 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.

New Mexico· 31st of 51

$275

AK $955HI $166

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.