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Custom Mould For A Made-To-Measure Breast Implant

New York 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.

Facilitymedian $4,571 · 10th–90th $269$11,2200%10%10th90th$4,571Professionalmedian $263 · 10th–90th $123$7240%10%20%10th90th$263$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$213.80
Median
$3,630.78
Typical High
$10,000.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$239.88
Typical High
$676.08
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$5,495.41
Typical High
$12,882.50
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$288.40
Typical High
$707.95
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$10,964.78
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$4,365.16
Typical High
$53,703.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$380.19
Typical High
$1,023.29
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$281.84
Typical High
$489.78
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$457.09
Typical High
$602.56
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$346.74
Typical High
$575.44
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$398.11
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$4,897.79
Typical High
$11,220.18
United
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$295.12
Typical High
$724.44
Univera
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$151.36
Typical High
$467.74
Univera
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$323.59
Typical High
$630.96