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North Carolina rates for HCPCS 19086

Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including magnetic resonance guidance (List separately in addition to code for primary procedure)

Facilitymedian $1,000 · 10th–90th $89–$5,2480%5%10th90th$1,000Professionalmedian $537 · 10th–90th $85–$1,9050%5%10%10th90th$537$20.0$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
$117.49 / $1,230.27 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $478.63 / $1,905.46
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,380.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $1,047.13 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $812.83 / $1,479.11
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $416.87 / $891.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $1,905.46
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $831.76 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $524.81 / $1,412.54
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $1,778.28 / $1,778.28
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,786.30 / $4,786.30