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Surgical Removal Of A Breast Lump Marked By Radiology

North Carolina rates for HCPCS 19125

A breast lump or abnormal area that isn't easily felt by hand is first marked by radiology, using a thin wire or small clip placed under imaging guidance, and then surgically removed through an open incision, guided by that marker. This version covers removal of a single marked area.

Rates data updated July 2026.

How much does Surgical Removal Of A Breast Lump Marked By Radiology cost?

$5,403

Typical total for the visit. In North Carolina, July 2026.

Insurers have agreed to pay about $5,403 for this procedure. That total is two separate charges: $617 to the doctor who performs it, and $4,786 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$617$479 to $1,047
Facility feeThe hospital or surgery center$4,786$759 to $7,762

How much rates vary

Facilitymedian $4,786 · 10th to 90th $562 to $8,710Professionalmedian $617 · 10th to 90th $427 to $1,549
$100.0$500.0$2.0K$10.0K$50.0Kfacility $4,786professional $617

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
$562.34
Median
$5,128.61
Typical High
$8,709.64
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$9,332.54
Median
$9,332.54
Typical High
$9,332.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$602.56
Typical High
$1,584.89
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$691.83
Typical High
$812.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$812.83
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$741.31
Typical High
$1,318.26
Medcost
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$616.60
Typical High
$912.01
Medcost
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$1,479.11
United
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$6,918.31
Typical High
$12,882.50
United
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$549.54
Typical High
$1,122.02
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$8,912.51
Median
$8,912.51
Typical High
$45,708.82
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$4,073.80
Median
$4,073.80
Typical High
$5,011.87

Where North Carolina sits

The same service costs 6.5 times more in Delaware than in Montana. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeNorth Carolina $5,403 · 22nd of 50
DE $10,274MT $1,572

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.