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Open Biopsy Of A Breast Lump

Iowa 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?

$4,057

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

Insurers have agreed to pay about $4,057 for this procedure. That total is two separate charges: $427 to the doctor who performs it, and $3,631 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$427$316 to $741
Facility feeThe hospital or surgery center$3,631$891 to $6,310

How much rates vary

Facilitymedian $3,631 · 10th to 90th $490 to $8,511Professionalmedian $427 · 10th to 90th $245 to $1,349
$200$500$1K$2K$5K$10Kfacility $3,631professional $427

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
$489.78
Median
$3,630.78
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$389.05
Typical High
$1,348.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$630.96
Typical High
$912.01
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$512.86
Typical High
$1,230.27
Medica
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$891.25
Typical High
$9,549.93
Medica
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$602.56
Typical High
$1,905.46
Midlands
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$691.83
Typical High
$912.01
Midlands
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$645.65
Typical High
$933.25
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$416.87
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$4,365.16
Median
$6,456.54
Typical High
$10,232.93
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$436.52
Typical High
$812.83
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$478.63
Typical High
$776.25

Where Iowa 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

Iowa· 18th of 50

$4,057

$427 physician + $3,631 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.