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Open Biopsy Of A Breast Lump

New Mexico 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?

$4,500

Typical total for the visit. In New Mexico, July 2026.

Insurers have agreed to pay about $4,500 for this procedure. That total is two separate charges: $331 to the doctor who performs it, and $4,169 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$331$257 to $398
Facility feeThe hospital or surgery center$4,169$550 to $8,913

How much rates vary

Facilitymedian $4,169 · 10th to 90th $339 to $12,882Professionalmedian $331 · 10th to 90th $174 to $631
$50$200$1K$5Kfacility $4,169professional $331

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
$338.84
Median
$549.54
Typical High
$5,011.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$323.59
Typical High
$1,202.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$8,912.51
Typical High
$14,125.38
BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$363.08
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$380.19
Typical High
$588.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$467.74
Providence
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$389.05
Typical High
$724.44
Providence
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$389.05
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$6,918.31
Typical High
$16,982.44
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$380.19
Typical High
$575.44

Where New Mexico 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

New Mexico· 15th of 50

$4,500

$331 physician + $4,169 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.