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Open Biopsy of a Chest-Area Spinal Bone

South Dakota 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?

$1,337

Typical total for the visit. In South Dakota, July 2026.

Insurers have agreed to pay about $1,337 for this procedure. That total is two separate charges: $676 to the doctor who performs it, and $661 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$676$398 to $891
Facility feeThe hospital or surgery center$661$589 to $3,548

How much rates vary

Facilitymedian $661 · 10th to 90th $457 to $4,365Professionalmedian $676 · 10th to 90th $324 to $1,096
$500$1K$2K$5Kfacility $661professional $676

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$3,548.13
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$380.19
Typical High
$776.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$891.25
Typical High
$1,096.48
Medica
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$645.65
Typical High
$1,000.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$691.83
Typical High
$4,677.35
Midlands
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$870.96
Typical High
$870.96
Midlands
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$831.76
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$660.69
Typical High
$776.25
United
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$660.69
Typical High
$1,071.52
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$831.76
Typical High
$1,000.00

Where South Dakota 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

South Dakota· 46th of 50

$1,337

$676 physician + $661 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.