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Open Biopsy Of A Breast Lump

Colorado 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?

$5,819

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

Insurers have agreed to pay about $5,819 for this procedure. That total is two separate charges: $324 to the doctor who performs it, and $5,495 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$324$229 to $407
Facility feeThe hospital or surgery center$5,495$3,090 to $9,550

How much rates vary

Facilitymedian $5,495 · 10th to 90th $324 to $12,882Professionalmedian $324 · 10th to 90th $209 to $603
$200$500$1K$2K$5K$10K$20Kfacility $5,495professional $324

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
$323.59
Median
$3,548.13
Typical High
$7,413.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$295.12
Typical High
$575.44
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,786.30
Median
$9,549.93
Typical High
$15,135.61
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$407.38
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$407.38
Typical High
$630.96
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$371.54
Typical High
$537.03
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$501.19
Typical High
$1,479.11
Select Health
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$436.52
Typical High
$758.58
Select Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$229.09
Typical High
$323.59
United
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$5,011.87
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$407.38
Typical High
$660.69

Where Colorado 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

Colorado· 8th of 50

$5,819

$324 physician + $5,495 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.