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Open Biopsy Of A Breast Lump

Kentucky 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?

$2,579

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

Insurers have agreed to pay about $2,579 for this procedure. That total is two separate charges: $288 to the doctor who performs it, and $2,291 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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$288$214 to $501
Facility feeThe hospital or surgery center$2,291$1,413 to $3,802

How much rates vary

Facilitymedian $2,291 · 10th to 90th $380 to $5,495Professionalmedian $288 · 10th to 90th $195 to $617
$200$500$1K$2K$5K$10Kfacility $2,291professional $288

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
$213.80
Median
$851.14
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$275.42
Typical High
$602.56
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$2,398.83
Typical High
$4,365.16
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$416.87
Typical High
$676.08
CareSource
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$281.84
Typical High
$331.13
CareSource
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$288.40
Typical High
$338.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$380.19
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$407.38
Typical High
$1,949.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$3,467.37
Typical High
$6,456.54
United
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$302.00
Typical High
$562.34

Where Kentucky 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

Kentucky· 32nd of 50

$2,579

$288 physician + $2,291 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.