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Open Biopsy of a Chest-Area Spinal Bone

Pennsylvania rates for HCPCS 20250

This procedure surgically opens the skin and tissue to reach a vertebra, one of the bones of the spine, in the chest (thoracic) region, and removes a tissue sample directly from the bone. It is used to diagnose the cause of a suspicious spinal bone lesion, such as infection, cancer, or an unexplained fracture, when less invasive sampling has not given a clear answer. The incision is closed after the sample is taken.

Rates data updated July 2026.

How much does Open Biopsy of a Chest-Area Spinal Bone cost?

$4,673

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

Insurers have agreed to pay about $4,673 for this procedure. That total is two separate charges: $407 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 9 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$407$372 to $501
Facility feeThe hospital or surgery center$4,266$2,630 to $6,607

How much rates vary

Facilitymedian $4,266 · 10th to 90th $1,023 to $8,318Professionalmedian $407 · 10th to 90th $347 to $871
$500$1K$2K$5K$10Kfacility $4,266professional $407

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
$1,023.29
Median
$4,265.80
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$398.11
Typical High
$1,023.29
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$6,165.95
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$588.84
Typical High
$660.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$467.74
Typical High
$776.25
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$616.60
Typical High
$794.33
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$489.78
Typical High
$794.33
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$3,981.07
Typical High
$8,317.64
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$407.38
Typical High
$1,995.26
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$446.68
Typical High
$467.74
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$1,949.84
Typical High
$3,388.44
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$380.19
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$4,365.16
Typical High
$9,549.93
United
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$446.68
Typical High
$794.33

Where Pennsylvania sits

The same service costs 13.5 times more in Indiana than in West Virginia. 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

Pennsylvania· 22nd of 50

$4,673

$407 physician + $4,266 facility

IN $10,640WV $788

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.