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Open Biopsy Of A Breast Lump

Missouri 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?

$2,483

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

Insurers have agreed to pay about $2,483 for this procedure. That total is two separate charges: $295 to the doctor who performs it, and $2,188 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$295$229 to $407
Facility feeThe hospital or surgery center$2,188$1,122 to $3,388

How much rates vary

Facilitymedian $2,188 · 10th to 90th $347 to $5,623Professionalmedian $295 · 10th to 90th $195 to $631
$200$500$1K$2K$5K$10Kfacility $2,188professional $295

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
$269.15
Median
$2,511.89
Typical High
$5,754.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$275.42
Typical High
$1,819.70
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,819.70
Typical High
$3,981.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$309.03
Typical High
$512.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$346.74
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$354.81
Typical High
$645.65
Medica
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$512.86
Typical High
$16,218.10
Medica
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$489.78
Typical High
$2,398.83
United
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$3,019.95
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$323.59
Typical High
$549.54

Where Missouri 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

Missouri· 34th of 50

$2,483

$295 physician + $2,188 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.