go back

Custom Mould For A Made-To-Measure Breast Implant

Nevada 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.

Facilitymedian $2,570 · 10th–90th $132$7,7620%10%10th90th$2,570Professionalmedian $234 · 10th–90th $132$7590%10%20%10th90th$234$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$2,570.40
Typical High
$10,232.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$234.42
Typical High
$758.58
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,466.84
Median
$6,025.60
Typical High
$7,762.47
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$251.19
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,621.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$234.42
Typical High
$457.09
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$239.88
Typical High
$467.74
Hometown Health
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$436.52
Select Health
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$263.03
Typical High
$288.40
Select Health
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
United
Setting
Facility
Modifier
Global
Typical Low
$1,230.27
Median
$2,511.89
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$239.88
Typical High
$478.63