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Open Biopsy Of A Breast Lump

Florida 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?

$5,193

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

Insurers have agreed to pay about $5,193 for this procedure. That total is two separate charges: $295 to the doctor who performs it, and $4,898 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$295$224 to $437
Facility feeThe hospital or surgery center$4,898$2,138 to $9,333

How much rates vary

Facilitymedian $4,898 · 10th to 90th $871 to $13,490Professionalmedian $295 · 10th to 90th $191 to $646
$200$500$1K$2K$5K$10K$20Kfacility $4,898professional $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
$776.25
Median
$4,073.80
Typical High
$11,481.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$295.12
Typical High
$676.08
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$147.91
Typical High
$151.36
AvMed
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$4,073.80
Typical High
$11,220.18
AvMed
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$295.12
Typical High
$389.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$1,548.82
Typical High
$1,819.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$346.74
Typical High
$602.56
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$6,165.95
Median
$12,302.69
Typical High
$23,442.29
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$263.03
Typical High
$436.52
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$5,623.41
Typical High
$9,772.37
United
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$331.13
Typical High
$602.56
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$245.47
Typical High
$371.54

Where Florida 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

Florida· 12th of 50

$5,193

$295 physician + $4,898 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.