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Open Biopsy Of A Breast Lump

Delaware 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?

$295

Typical physician fee. In Delaware, July 2026.

Insurers have agreed to pay about $295 for this service. Most negotiated rates run $195 to $407.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $9,333 · 10th to 90th $1,000 to $9,333Professionalmedian $295 · 10th to 90th $195 to $603
$200$500$1K$2K$5K$10Kfacility $9,333professional $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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$9,332.54
Typical High
$9,332.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$295.12
Typical High
$691.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$316.23
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$1,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$302.00
Typical High
$524.81

Where Delaware 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.

Delaware· 49th of 51

$295

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.