go back

Open Biopsy Of A Breast Lump

Maryland 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?

$528

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

Insurers have agreed to pay about $528 for this procedure. That total is two separate charges: $324 to the doctor who performs it, and $204 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$324$229 to $513
Facility feeThe hospital or surgery center$204$126 to $339

How much rates vary

Facilitymedian $204 · 10th to 90th $55 to $1,622Professionalmedian $324 · 10th to 90th $195 to $933
$100$200$500$1K$2Kfacility $204professional $324

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
$54.95
Median
$204.17
Typical High
$338.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$295.12
Typical High
$1,202.26
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,621.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$354.81
Typical High
$724.44
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$426.58
Typical High
$676.08
United
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$346.74
Typical High
$616.60
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$478.63
Typical High
$537.03

Where Maryland 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

Maryland· 50th of 50

$528

$324 physician + $204 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.