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Oklahoma rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $2,951 · 10th–90th $275–$6,7610%10%10th90th$2,951Professionalmedian $229 · 10th–90th $126–$3800%10%20%10th90th$229$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $2,630.27 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $229.09 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $229.09 / $389.05
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $645.65 / $6,165.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $323.59 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $3,981.07 / $8,128.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $213.80 / $338.84