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Open Biopsy Of A Breast Lump

South Carolina 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?

$5,572

Typical total for the visit. In South Carolina, July 2026.

Insurers have agreed to pay about $5,572 for this procedure. That total is two separate charges: $324 to the doctor who performs it, and $5,248 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 $363
Facility feeThe hospital or surgery center$5,248$407 to $9,120

How much rates vary

Facilitymedian $5,248 · 10th to 90th $251 to $15,849Professionalmedian $324 · 10th to 90th $219 to $603
$50$200$1K$5K$20Kfacility $5,248professional $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
$239.88
Median
$5,623.41
Typical High
$21,877.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$323.59
Typical High
$602.56
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$5,888.44
Typical High
$10,000.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$354.81
Typical High
$645.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$1,949.84
Typical High
$2,511.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$371.54
Typical High
$691.83
Medcost
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$363.08
Typical High
$707.95
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$10,715.19
Typical High
$16,982.44
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$316.23
Typical High
$562.34

Where South Carolina 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

South Carolina· 10th of 50

$5,572

$324 physician + $5,248 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.