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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.

Facilitymedian $741 · 10th–90th $55$2,9510%20%10th90th$741Professionalmedian $302 · 10th–90th $195$7080%10%10th90th$302$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$741.31
Typical High
$2,951.21
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$295.12
Typical High
$724.44
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$281.84
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
$363.08
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
$204.17
Median
$331.13
Typical High
$588.84
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$478.63
Typical High
$537.03