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Custom Mould For A Made-To-Measure Breast Implant

Tennessee 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?

$295

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $295 for this service. The price depends on where it is billed: about $229 from a physician practice, and about $3,090 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 5 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$229$151 to $316
FacilityA hospital or hospital-owned outpatient department$3,090$1,862 to $4,677

How much rates vary

Facilitymedian $3,090 · 10th to 90th $708 to $6,761Professionalmedian $229 · 10th to 90th $123 to $525
$100$200$500$1K$2K$5K$10Kfacility $3,090professional $229

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
$524.81
Median
$2,398.83
Typical High
$6,456.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$223.87
Typical High
$331.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$4,073.80
Typical High
$5,888.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$302.00
Typical High
$537.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$281.84
Typical High
$489.78
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$8,912.51
Typical High
$8,912.51
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$2,137.96
Median
$2,290.87
Typical High
$2,290.87
United
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$4,466.84
Typical High
$7,585.78
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$269.15
Typical High
$524.81

Where Tennessee 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.

Tennessee· 20th of 51

$295

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.