go back

Open Biopsy Of A Breast Lump

Idaho 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?

$1,263

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

Insurers have agreed to pay about $1,263 for this procedure. That total is two separate charges: $372 to the doctor who performs it, and $891 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$372$309 to $501
Facility feeThe hospital or surgery center$891$398 to $5,623

How much rates vary

Facilitymedian $891 · 10th to 90th $309 to $8,710Professionalmedian $372 · 10th to 90th $224 to $617
$200$500$1K$2K$5K$10Kfacility $891professional $372

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
$398.11
Median
$602.56
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$338.84
Typical High
$602.56
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$4,073.80
Typical High
$9,772.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$501.19
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$380.19
Typical High
$575.44
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$398.11
Typical High
$691.83
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$436.52
Typical High
$691.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$6,165.95
Median
$8,511.38
Typical High
$12,589.25
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$416.87
Typical High
$562.34
Select Health
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$3,548.13
Typical High
$6,025.60
Select Health
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$316.23
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$12,302.69
Typical High
$12,302.69
United
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$371.54
Typical High
$602.56

Where Idaho 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

Idaho· 44th of 50

$1,263

$372 physician + $891 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.