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Custom Mould For A Made-To-Measure Breast Implant

Oregon 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.

How much does Custom Mould For A Made-To-Measure Breast Implant cost?

$427

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $427 for this service. The price depends on where it is billed: about $417 from a physician practice, and about $525 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$417$257 to $575
FacilityA hospital or hospital-owned outpatient department$525$363 to $617

How much rates vary

Facilitymedian $525 · 10th to 90th $251 to $9,333Professionalmedian $417 · 10th to 90th $200 to $759
$100$500$2K$10Kfacility $525professional $417

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$707.95
Typical High
$17,378.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$416.87
Typical High
$870.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$380.19
Typical High
$741.31
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$371.54
Typical High
$707.95
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$331.13
Typical High
$588.84
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$436.52
Typical High
$676.08
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$524.81
Typical High
$562.34
Providence
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$338.84
Typical High
$645.65
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$363.08
Typical High
$691.83
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$9,120.11
Median
$12,589.25
Typical High
$15,135.61
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$489.78
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$11,748.98
Typical High
$25,118.86
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$389.05
Typical High
$724.44

Where Oregon sits

The same service costs 21.4 times more in California than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Oregon· 8th of 51

$427

CA $4,571WV $214

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.