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Open Biopsy Of A Breast Lump

Connecticut 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?

$5,986

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

Insurers have agreed to pay about $5,986 for this procedure. That total is two separate charges: $363 to the doctor who performs it, and $5,623 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$363$275 to $575
Facility feeThe hospital or surgery center$5,623$4,571 to $7,943

How much rates vary

Facilitymedian $5,623 · 10th to 90th $3,090 to $11,220Professionalmedian $363 · 10th to 90th $209 to $776
$200$500$1K$2K$5K$10Kfacility $5,623professional $363

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
$1,698.24
Median
$5,248.07
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$309.03
Typical High
$831.76
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$11,748.98
Typical High
$13,803.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$457.09
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$467.74
Typical High
$851.14
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$707.95
Health New England
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$691.83
United
Setting
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$7,244.36
Typical High
$11,220.18
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$380.19
Typical High
$676.08

Where Connecticut 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

Connecticut· 7th of 50

$5,986

$363 physician + $5,623 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.