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Rhode Island rates for HCPCS 19396

Preparation of moulage for custom breast implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $3,235.94 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $239.88 / $524.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $229.09 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $302.00 / $602.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $5,128.61 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $229.09 / $489.78