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Partial Breast Removal (Lumpectomy)

Virginia 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?

$5,042

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

Insurers have agreed to pay about $5,042 for this procedure. That total is two separate charges: $776 to the doctor who performs it, and $4,266 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$776$676 to $1,096
Facility feeThe hospital or surgery center$4,266$1,148 to $6,457

How much rates vary

Facilitymedian $4,266 · 10th to 90th $741 to $8,511Professionalmedian $776 · 10th to 90th $562 to $1,738
$100$200$500$1K$2K$5K$10Kfacility $4,266professional $776

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
$851.14
Median
$4,365.16
Typical High
$8,128.31
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$70.79
Median
$70.79
Typical High
$7,413.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$741.31
Typical High
$2,041.74
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,888.44
Median
$6,760.83
Typical High
$7,413.10
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$870.96
Typical High
$1,380.38
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$954.99
Typical High
$5,495.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$776.25
Typical High
$1,513.56
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$724.44
Typical High
$1,905.46
Medcost
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$724.44
Typical High
$1,513.56
Medcost
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$831.76
Typical High
$1,230.27
Sentara
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$851.14
Typical High
$8,709.64
Sentara
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$851.14
Typical High
$8,709.64
United
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$6,606.93
Typical High
$13,489.63
United
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$660.69
Typical High
$1,288.25

Where Virginia 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

Virginia· 33rd of 51

$5,042

$776 physician + $4,266 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.