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Open Biopsy Of A Breast Lump

Michigan 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?

$3,208

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

Insurers have agreed to pay about $3,208 for this procedure. That total is two separate charges: $324 to the doctor who performs it, and $2,884 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$324$240 to $398
Facility feeThe hospital or surgery center$2,884$407 to $4,898

How much rates vary

Facilitymedian $2,884 · 10th to 90th $282 to $7,079Professionalmedian $324 · 10th to 90th $191 to $501
$200$500$1K$2K$5K$10Kfacility $2,884professional $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
$281.84
Median
$2,884.03
Typical High
$7,079.46
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$263.03
Typical High
$398.11
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$501.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$501.19
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$346.74
Typical High
$562.34
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$1,000.00
Typical High
$4,897.79
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$371.54
Typical High
$549.54
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
United
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$5,248.07
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$346.74
Typical High
$501.19

Where Michigan 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

Michigan· 27th of 50

$3,208

$324 physician + $2,884 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.