go back

Custom Mould For A Made-To-Measure Breast Implant

West Virginia 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.

Facilitymedian $251 · 10th–90th $135$1,6980%20%10th90th$251Professionalmedian $229 · 10th–90th $120$2880%20%10th90th$229$50.0$200.0$1.0K$5.0K

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
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$251.19
Typical High
$1,698.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$229.09
Typical High
$288.40
CareSource
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$181.97
CareSource
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$239.88
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$275.42
Typical High
$2,137.96
United
Setting
Facility
Modifier
Global
Typical Low
$2,884.03
Median
$2,884.03
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$346.74