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Open Biopsy Of A Breast Lump

Vermont 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?

$331

Typical physician fee. In Vermont, July 2026.

Insurers have agreed to pay about $331 for this service. Most negotiated rates run $234 to $355.

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

Professionalmedian $331 · 10th to 90th $234 to $479
$200$500$1Kprofessional $331

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
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$354.81
BCBS
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$363.08
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$407.38
Typical High
$812.83

Where Vermont 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.

Vermont· 44th of 51

$331

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.