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Partial Breast Removal (Lumpectomy)

Ohio 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?

$6,203

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

Insurers have agreed to pay about $6,203 for this procedure. That total is two separate charges: $708 to the doctor who performs it, and $5,495 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$708$490 to $1,047
Facility feeThe hospital or surgery center$5,495$3,020 to $7,413

How much rates vary

Facilitymedian $5,495 · 10th to 90th $1,072 to $9,772Professionalmedian $708 · 10th to 90th $363 to $1,820
$50$200$1K$5Kfacility $5,495professional $708

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
$1,071.52
Median
$5,754.40
Typical High
$9,772.37
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$8,128.31
Median
$8,128.31
Typical High
$8,128.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$954.99
Typical High
$6,309.57
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$741.31
Typical High
$933.25
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
$446.68
Typical High
$851.14
CareSource
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$724.44
Typical High
$851.14
CareSource
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$794.33
Typical High
$851.14
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$21,379.62
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,318.26
Cigna
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$831.76
Typical High
$1,318.26
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$3,801.89
Typical High
$12,882.50
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$851.14
Typical High
$1,348.96
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$794.33
Typical High
$1,445.44
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
$489.78
Median
$724.44
Typical High
$1,348.96

Where Ohio 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

Ohio· 20th of 51

$6,203

$708 physician + $5,495 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.