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Surgical Removal Of A Breast Lump Marked By Radiology

Pennsylvania 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?

$5,666

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

Insurers have agreed to pay about $5,666 for this procedure. That total is two separate charges: $537 to the doctor who performs it, and $5,129 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 13 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$537$437 to $759
Facility feeThe hospital or surgery center$5,129$2,818 to $8,318

How much rates vary

Facilitymedian $5,129 · 10th to 90th $776 to $9,772Professionalmedian $537 · 10th to 90th $398 to $1,122
$100.0$500.0$2.0K$10.0K$50.0Kfacility $5,129professional $537

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
$660.69
Median
$5,128.61
Typical High
$9,332.54
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$977.24
Median
$5,495.41
Typical High
$19,952.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$537.03
Typical High
$1,148.15
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$691.83
Typical High
$691.83
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$3,715.35
Typical High
$23,442.29
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$501.19
Typical High
$691.83
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,248.07
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$851.14
Typical High
$1,000.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$588.84
Typical High
$977.24
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,096.48
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$676.08
Typical High
$1,071.52
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$9,120.11
Typical High
$14,125.38
Highmark BCBS
Setting
Facility
Modifier
50 · Both sides
Typical Low
$6,025.60
Median
$10,471.29
Typical High
$13,489.63
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$562.34
Typical High
$812.83
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$3,801.89
Typical High
$23,442.29
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$512.86
Typical High
$691.83
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$5,248.07
Typical High
$11,220.18
Martin's Point
Setting
Facility
Modifier
50 · Both sides
Typical Low
$977.24
Median
$5,495.41
Typical High
$19,952.62
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$549.54
Typical High
$1,148.15
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$524.81
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$1,949.84
Typical High
$3,388.44
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$489.78
Typical High
$562.34
United
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$3,890.45
Typical High
$11,481.54
United
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$549.54
Typical High
$1,023.29

Where Pennsylvania 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 feePennsylvania $5,666 · 20th 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.