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Open Biopsy Of A Breast Lump

Virginia 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?

$2,909

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

Insurers have agreed to pay about $2,909 for this procedure. That total is two separate charges: $339 to the doctor who performs it, and $2,570 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$339$251 to $407
Facility feeThe hospital or surgery center$2,570$355 to $5,888

How much rates vary

Facilitymedian $2,570 · 10th to 90th $251 to $8,710Professionalmedian $339 · 10th to 90th $219 to $692
$200$500$1K$2K$5K$10Kfacility $2,570professional $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
$309.03
Median
$3,019.95
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$316.23
Typical High
$1,096.48
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,888.44
Median
$6,760.83
Typical High
$7,413.10
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$346.74
Typical High
$549.54
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$389.05
Typical High
$4,365.16
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$346.74
Typical High
$630.96
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$407.38
Typical High
$1,096.48
Medcost
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$489.78
Typical High
$794.33
Medcost
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$380.19
Typical High
$616.60
Sentara
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$295.12
Typical High
$8,709.64
Sentara
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$436.52
Typical High
$8,709.64
United
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$6,606.93
Typical High
$13,489.63
United
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$323.59
Typical High
$575.44

Where Virginia 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

Virginia· 30th of 50

$2,909

$339 physician + $2,570 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.