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Ohio 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 $1,950 · 10th–90th $158–$9,5500%10%10th90th$1,950Professionalmedian $302 · 10th–90th $78–$1,2300%10%10th90th$302$1.0$5.0$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
$158.49 / $1,995.26 / $10,232.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $302.00 / $1,412.54
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $100.00 / $263.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $398.11 / $1,148.15
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $89.13 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $575.44 / $1,148.15
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $575.44 / $1,148.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $63.10
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $537.03 / $1,047.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $1,047.13 / $3,235.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $489.78 / $1,148.15