go back

Partial Breast Removal (Lumpectomy)

Michigan rates for HCPCS 19301

A portion of breast tissue containing a lump or abnormal area is surgically removed, while the rest of the breast is preserved, rather than removing the entire breast. It is a common treatment approach for an early-stage breast cancer or certain other breast abnormalities.

Rates data updated July 2026.

How much does Partial Breast Removal (Lumpectomy) cost?

$6,042

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

Insurers have agreed to pay about $6,042 for this procedure. That total is two separate charges: $794 to the doctor who performs it, and $5,248 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$794$631 to $1,047
Facility feeThe hospital or surgery center$5,248$3,467 to $8,128

How much rates vary

Facilitymedian $5,248 · 10th to 90th $1,622 to $9,120Professionalmedian $794 · 10th to 90th $537 to $1,479
$200$500$1K$2K$5K$10Kfacility $5,248professional $794

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
$1,621.81
Median
$5,370.32
Typical High
$9,120.11
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$794.33
Typical High
$1,348.96
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$676.08
Typical High
$1,258.93
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,479.11
Median
$1,479.11
Typical High
$1,479.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$1,380.38
Typical High
$1,479.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$831.76
Typical High
$1,659.59
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$1,778.28
Typical High
$5,754.40
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$794.33
Typical High
$1,122.02
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59
United
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$5,248.07
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$794.33
Typical High
$1,071.52

Where Michigan sits

The same service costs 4.9 times more in Wyoming than in Montana. 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

Michigan· 23rd of 51

$6,042

$794 physician + $5,248 facility

WY $10,633MT $2,180

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.