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Breast Wire Localization, First Lesion

Pennsylvania rates for HCPCS 19281

This procedure places a thin guide wire into the breast under mammography guidance to mark the exact location of an abnormal area before a surgeon removes it. It is done shortly before surgery so the surgeon can find and remove precisely the right tissue.

Facilitymedian $2,188 · 10th–90th $224$5,8880%5%10%10th90th$2,188Professionalmedian $209 · 10th–90th $87$7410%10%20%10th90th$209$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$223.87
Median
$2,137.96
Typical High
$5,888.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$208.93
Typical High
$776.25
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$7,413.10
Median
$7,413.10
Typical High
$7,413.10
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,258.93
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$354.81
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$218.78
Typical High
$426.58
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$398.11
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$281.84
Typical High
$416.87
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$3,630.78
Typical High
$6,760.83
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$3,162.28
Typical High
$9,332.54
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$100.00
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$1,584.89
Typical High
$6,165.95
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$208.93
Typical High
$588.84
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$478.63
Typical High
$851.14
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$234.42
Typical High
$275.42
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$239.88
Typical High
$309.03
United
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$2,951.21
Typical High
$5,888.44
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$204.17
Typical High
$380.19