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Open Biopsy Of A Breast Lump

Rhode Island 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?

$269

Typical physician fee. In Rhode Island, July 2026.

Insurers have agreed to pay about $269 for this service. Most negotiated rates run $229 to $363.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3,715 · 10th to 90th $2,570 to $8,710Professionalmedian $263 · 10th to 90th $162 to $479
$200$500$1K$2K$5K$10Kfacility $3,715professional $263

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
$2,089.30
Median
$2,754.23
Typical High
$3,981.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$263.03
Typical High
$346.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$323.59
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$363.08
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$4,677.35
Typical High
$8,709.64
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$331.13
Typical High
$549.54

Where Rhode Island 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.

Rhode Island· 51st of 51

$269

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.