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New Mexico rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $457 · 10th–90th $200–$8,7100%10%20%10th90th$457Professionalmedian $234 · 10th–90th $126–$4680%10%20%10th90th$234$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $457.09 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $234.42 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $478.63
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $380.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $269.15 / $588.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $275.42 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $8,128.31 / $16,982.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $251.19 / $501.19