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Oregon rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $525 · 10th–90th $251–$9,5500%20%10th90th$525Professionalmedian $269 · 10th–90th $123–$6760%10%10th90th$269$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

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
$281.84 / $616.60 / $13,182.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $234.42 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $371.54 / $741.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $371.54 / $707.95
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $354.81 / $676.08
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $436.52 / $707.95
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $524.81 / $562.34
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $338.84 / $645.65
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $363.08 / $691.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $12,022.64 / $14,791.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $489.78 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $13,182.57 / $25,118.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $380.19 / $707.95