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Virginia rates for HCPCS 19396

Preparation of moulage for custom breast implant

Facilitymedian $3,236 · 10th–90th $155–$8,9130%5%10th90th$3,236Professionalmedian $251 · 10th–90th $129–$4370%10%10th90th$251$100.0$500.0$2.0K$10.0K

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
$162.18 / $3,630.78 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $229.09 / $338.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,888.44 / $6,760.83 / $7,413.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $263.03 / $426.58
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $194.98 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $251.19 / $467.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $338.84 / $912.01
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $263.03 / $676.08
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $263.03 / $467.74
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $194.98 / $10,000.00
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $380.19 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $8,317.64 / $17,378.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $229.09 / $467.74