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Surgical Removal of a Breast Lump

Ohio rates for HCPCS 19120

A surgeon makes an incision to remove a lump, cyst, or other abnormal area of tissue from the breast, along with a margin of surrounding tissue, and sends it to a lab for examination. This can be done to treat a benign growth or to remove and evaluate tissue that may be cancerous. It differs from a needle biopsy in that the tissue is removed surgically rather than sampled with a needle.

Rates data updated July 2026.

How much does Surgical Removal of a Breast Lump cost?

$5,920

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

Insurers have agreed to pay about $5,920 for this procedure. That total is two separate charges: $550 to the doctor who performs it, and $5,370 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 9 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$550$417 to $741
Facility feeThe hospital or surgery center$5,370$2,512 to $7,079

How much rates vary

Facilitymedian $5,370 · 10th to 90th $575 to $10,233Professionalmedian $550 · 10th to 90th $355 to $1,072
$200$500$1K$2K$5K$10Kfacility $5,370professional $550

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
$549.54
Median
$5,495.41
Typical High
$10,000.00
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$954.99
Median
$5,370.32
Typical High
$14,454.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$602.56
Typical High
$2,630.27
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$478.63
Typical High
$549.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$3,548.13
Typical High
$15,135.61
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$467.74
Typical High
$812.83
CareSource
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$416.87
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$21,379.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$588.84
Typical High
$954.99
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$6,165.95
Typical High
$15,135.61
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$616.60
Typical High
$933.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$199.53
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$616.60
Typical High
$1,071.52
United
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$4,168.69
Typical High
$7,762.47
United
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$512.86
Typical High
$891.25

Where Ohio sits

The same service costs 6.3 times more in Indiana than in North Dakota. 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

Ohio· 15th of 51

$5,920

$550 physician + $5,370 facility

IN $8,607ND $1,372

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.