go back

Pennsylvania rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $4,266 · 10th–90th $832$8,3180%10%10th90th$4,266Professionalmedian $229 · 10th–90th $123$4680%10%20%10th90th$229$50.0$200.0$1.0K$5.0K$20.0K

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
$831.76 / $4,786.30 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $229.09 / $426.58
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $7,585.78 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $354.81 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $239.88 / $457.09
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $501.19
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $309.03 / $478.63
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $3,630.78 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $229.09 / $389.05
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $457.09 / $630.96
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $263.03 / $331.13
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $263.03 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $5,011.87 / $12,589.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $223.87 / $426.58