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Open Biopsy Of A Breast Lump

Indiana 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?

$8,991

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

Insurers have agreed to pay about $8,991 for this procedure. That total is two separate charges: $282 to the doctor who performs it, and $8,710 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$282$219 to $389
Facility feeThe hospital or surgery center$8,710$3,236 to $14,791

How much rates vary

Facilitymedian $8,710 · 10th to 90th $550 to $17,783Professionalmedian $282 · 10th to 90th $186 to $537
$200$500$1K$2K$5K$10K$20Kfacility $8,710professional $282

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
$245.47
Median
$2,454.71
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$269.15
Typical High
$363.08
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$11,481.54
Typical High
$18,620.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$407.38
Typical High
$602.56
CareSource
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$218.78
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$354.81
Typical High
$676.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$346.74
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$5,623.41
Typical High
$10,715.19
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$316.23
Typical High
$501.19

Where Indiana 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

Indiana· 2nd of 50

$8,991

$282 physician + $8,710 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.