go back

Custom Mould For A Made-To-Measure Breast Implant

Wyoming 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 October 2026.

How much does Custom Mould For A Made-To-Measure Breast Implant cost?

$427

Typical negotiated rate. In Wyoming, October 2026.

Insurers have agreed to pay about $427 for this service. The price depends on where it is billed: about $398 from a physician practice, and about $4,074 from a hospital or other facility.

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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$398$339 to $631
FacilityA hospital or hospital-owned outpatient department$4,074$3,802 to $4,074

How much rates vary

Facilitymedian $4,074 · 10th to 90th $2,344 to $4,266Professionalmedian $398 · 10th to 90th $275 to $676
$200$500$1K$2K$5K$10Kfacility $4,074professional $398

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$281.84
Aetna
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$281.84
BCBS Wyoming
Setting
Facility
Modifier
None
Typical Low
$4,073.80
Median
$4,073.80
Typical High
$4,073.80
BCBS Wyoming
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$426.58
Typical High
$676.08
BCBS Wyoming
Setting
Professional
Modifier
50 · Both sides
Typical Low
$331.13
Median
$537.03
Typical High
$1,023.29
Cigna
Setting
Facility
Modifier
None
Typical Low
$2,344.23
Median
$3,801.89
Typical High
$5,495.41
Cigna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$389.05
Typical High
$676.08
United
Setting
Facility
Modifier
None
Typical Low
$2,137.96
Median
$4,168.69
Typical High
$14,125.38
United
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$457.09
Typical High
$776.25

Where Wyoming sits

The same service costs 5.8 times more in Alaska than in Hawaii. 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.

Wyoming· 8th of 51

$427

AK $955HI $166

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.