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Open Biopsy Of A Breast Lump

Tennessee 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?

$3,008

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

Insurers have agreed to pay about $3,008 for this procedure. That total is two separate charges: $316 to the doctor who performs it, and $2,692 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$316$240 to $398
Facility feeThe hospital or surgery center$2,692$1,820 to $4,074

How much rates vary

Facilitymedian $2,692 · 10th to 90th $617 to $6,607Professionalmedian $316 · 10th to 90th $191 to $776
$200$500$1K$2K$5K$10K$20Kfacility $2,692professional $316

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
$616.60
Median
$2,187.76
Typical High
$4,073.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$275.42
Typical High
$616.60
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$407.38
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$4,073.80
Typical High
$5,888.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$398.11
Typical High
$676.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$389.05
Typical High
$616.60
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$8,912.51
Median
$8,912.51
Typical High
$28,840.32
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$2,238.72
Median
$2,754.23
Typical High
$2,754.23
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$3,467.37
Typical High
$6,309.57
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$346.74
Typical High
$630.96

Where Tennessee 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

Tennessee· 29th of 50

$3,008

$316 physician + $2,692 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.