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Open Biopsy Of A Breast Lump

Washington, DC 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?

$347

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $347 for this service. Most negotiated rates run $229 to $794.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3,548 · 10th to 90th $347 to $7,762Professionalmedian $339 · 10th to 90th $224 to $457
$200$500$1K$2K$5K$10K$20Kfacility $3,548professional $339

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
$229.09
Median
$3,388.44
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$251.19
Typical High
$346.74
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$2,290.87
Typical High
$6,456.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$338.84
Typical High
$933.25
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$398.11
Typical High
$758.58
United
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$10,000.00
Typical High
$26,302.68
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$446.68
Typical High
$776.25

Where Washington, DC sits

The same service costs 7.9 times more in California than in Rhode Island. 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.

Washington, DC· 39th of 51

$347

CA $2,138RI $269

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.