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Partial Breast Removal (Lumpectomy)

North Carolina 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?

$6,202

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

Insurers have agreed to pay about $6,202 for this procedure. That total is two separate charges: $832 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$832$617 to $1,413
Facility feeThe hospital or surgery center$5,370$2,089 to $6,918

How much rates vary

Facilitymedian $5,370 · 10th to 90th $891 to $8,913Professionalmedian $832 · 10th to 90th $550 to $2,188
$1$10$100$1K$10Kfacility $5,370professional $832

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
$977.24
Median
$5,495.41
Typical High
$8,912.51
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$933.25
Median
$6,025.60
Typical High
$9,332.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$741.31
Typical High
$2,238.72
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$912.01
Typical High
$1,318.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$954.99
Typical High
$1,698.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$977.24
Typical High
$1,659.59
Medcost
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$741.31
Typical High
$1,202.26
Medcost
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$1,737.80
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
$416.87
Median
$691.83
Typical High
$1,479.11
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$8,912.51
Median
$8,912.51
Typical High
$45,708.82
Wellcare
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$4,677.35
Median
$5,754.40
Typical High
$5,754.40

Where North Carolina 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

North Carolina· 21st of 51

$6,202

$832 physician + $5,370 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.