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Open Biopsy Of A Breast Lump

Georgia 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?

$4,141

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

Insurers have agreed to pay about $4,141 for this procedure. That total is two separate charges: $339 to the doctor who performs it, and $3,802 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$339$263 to $468
Facility feeThe hospital or surgery center$3,802$1,622 to $5,623

How much rates vary

Facilitymedian $3,802 · 10th to 90th $513 to $7,586Professionalmedian $339 · 10th to 90th $209 to $646
$200$500$1K$2K$5K$10Kfacility $3,802professional $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
$338.84
Median
$4,570.88
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$331.13
Typical High
$660.69
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$3,090.30
Typical High
$6,606.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$398.11
Typical High
$616.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$1,949.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$407.38
Typical High
$691.83
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$380.19
Typical High
$575.44
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$457.09
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$3,890.45
Typical High
$6,918.31
United
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$363.08
Typical High
$630.96

Where Georgia 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

Georgia· 17th of 50

$4,141

$339 physician + $3,802 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.