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Pennsylvania 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 $468–$7,2440%5%10th90th$1,950Professionalmedian $537 · 10th–90th $78–$1,8200%10%10th90th$537$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$478.63 / $1,949.84 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $537.03 / $1,905.46
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,890.45 / $11,748.98
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $954.99 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $537.03 / $1,202.26
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $954.99
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $776.25 / $1,096.48
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $2,187.76
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,019.95 / $5,370.32
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $1,584.89 / $6,165.95
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $537.03 / $1,584.89
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,000.00 / $1,698.24
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $123.03 / $575.44
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $123.03 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $630.96 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $338.84 / $1,122.02