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Open Biopsy Of A Breast Lump

Utah 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?

$3,727

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

Insurers have agreed to pay about $3,727 for this procedure. That total is two separate charges: $339 to the doctor who performs it, and $3,388 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$339$288 to $501
Facility feeThe hospital or surgery center$3,388$2,455 to $4,571

How much rates vary

Facilitymedian $3,388 · 10th to 90th $229 to $6,026Professionalmedian $339 · 10th to 90th $224 to $617
$50$200$1K$5Kfacility $3,388professional $339

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
$229.09
Median
$3,235.94
Typical High
$4,897.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$338.84
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$371.54
Typical High
$562.34
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$776.25
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$7,585.78
Typical High
$11,481.54
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$407.38
Typical High
$575.44
Select Health
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Select Health
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$616.60
Typical High
$724.44
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$436.52
Typical High
$602.56
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$5,128.61
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$338.84
Typical High
$602.56

Where Utah 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

Utah· 24th of 50

$3,727

$339 physician + $3,388 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.