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Open Biopsy Of A Breast Lump

Maine 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?

$355

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $355 for this service. Most negotiated rates run $269 to $501.

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.

How much rates vary

Facilitymedian $6,310 · 10th to 90th $6,310 to $7,943Professionalmedian $355 · 10th to 90th $214 to $617
$200$500$1K$2K$5Kfacility $6,310professional $355

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$6,309.57
Median
$6,309.57
Typical High
$6,309.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$269.15
Typical High
$323.59
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$363.08
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$416.87
Typical High
$707.95
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$436.52
Typical High
$676.08
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$269.15
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$7,943.28
Median
$7,943.28
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$436.52
Typical High
$707.95

Where Maine sits

The same service costs 7.9 times more in California than in Rhode Island. 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.

Maine· 36th of 51

$355

CA $2,138RI $269

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.