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Open Biopsy Of A Breast Lump

Arizona rates for HCPCS 19101

A surgeon makes a small incision in the breast and removes a piece of a lump or abnormal area so it can be examined under a microscope. Only part of the abnormality is taken, enough to reach a diagnosis, rather than the whole of it. It is used when needle sampling has not given a clear answer or when a larger piece of tissue is needed.

Rates data updated July 2026.

How much does Open Biopsy Of A Breast Lump cost?

$3,385

Typical total for the visit. In Arizona, July 2026.

Insurers have agreed to pay about $3,385 for this procedure. That total is two separate charges: $295 to the doctor who performs it, and $3,090 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$295$229 to $417
Facility feeThe hospital or surgery center$3,090$2,042 to $4,677

How much rates vary

Facilitymedian $3,090 · 10th to 90th $501 to $6,607Professionalmedian $295 · 10th to 90th $195 to $1,202
$200$500$1K$2K$5Kfacility $3,090professional $295

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$3,311.31
Typical High
$6,760.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$288.40
Typical High
$1,202.26
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
BCBS
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$2,398.83
Typical High
$4,570.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$288.40
Typical High
$1,288.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$2,818.38
Typical High
$2,818.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$338.84
Typical High
$575.44
Medica
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$331.13
Typical High
$3,801.89
Medica
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$416.87
Typical High
$2,398.83
United
Setting
Facility
Modifier
Global
Typical Low
$2,187.76
Median
$3,311.31
Typical High
$5,370.32
United
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$309.03
Typical High
$524.81

Where Arizona sits

The same service costs 18.2 times more in Delaware than in Maryland. 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.

Physician feeFacility fee

Arizona· 26th of 50

$3,385

$295 physician + $3,090 facility

DE $9,628MD $528

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.