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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 July 2026.

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

$240

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $214 from a physician practice, and about $457 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$214$170 to $331
FacilityA hospital or hospital-owned outpatient department$457$245 to $6,761

How much rates vary

Facilitymedian $457 · 10th to 90th $200 to $9,550Professionalmedian $214 · 10th to 90th $107 to $759
$50$200$1K$5Kfacility $457professional $214

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
$199.53
Median
$457.09
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$213.80
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$269.15
Typical High
$478.63
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$380.19
Providence
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$269.15
Typical High
$588.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$275.42
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$9,549.93
Typical High
$16,982.44
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$251.19
Typical High
$501.19

Where New Mexico 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.

New Mexico· 45th of 51

$240

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.