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Open Biopsy Of A Breast Lump

North Dakota 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?

$806

Typical total for the visit. In North Dakota, July 2026.

Insurers have agreed to pay about $806 for this procedure. That total is two separate charges: $490 to the doctor who performs it, and $316 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$490$331 to $631
Facility feeThe hospital or surgery center$316$219 to $331

How much rates vary

Facilitymedian $316 · 10th to 90th $209 to $4,677Professionalmedian $490 · 10th to 90th $219 to $741
$200$500$1K$2K$5Kfacility $316professional $490

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
$208.93
Median
$316.23
Typical High
$2,511.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$302.00
Typical High
$331.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$575.44
Typical High
$776.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$524.81
Typical High
$851.14
Medica
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$371.54
Typical High
$1,000.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$602.56
Typical High
$724.44
United
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$5,128.61
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$436.52
Typical High
$758.58

Where North Dakota 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

North Dakota· 49th of 50

$806

$490 physician + $316 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.