Open Biopsy of a Neck or Lower Back Vertebra

Nationwide rates for HCPCS 20251

Through an incision, the surgeon exposes the body of a vertebra in the neck or the lower back and takes a sample of bone from it for laboratory examination. It is used when imaging shows infection, a growth, or unexplained destruction of the bone and a diagnosis is needed. Open sampling is chosen when a needle sample is not possible or has not given an answer.

Rates data updated July 2026.

How much does Open Biopsy of a Neck or Lower Back Vertebra cost?

$6,031

Typical total for the visit. Nationwide, July 2026.

Insurers have agreed to pay about $6,031 for this procedure. That total is two separate charges: $661 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.

11% physician fee89% facility fee

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 53 insurance carriers under federal price transparency rules.

What's inside this number

Part of the bill	Who charges it	Typical	Range
Physician feeThe doctor who performs it	The doctor who performs it	$661	$490 to $977
Facility feeThe hospital or surgery center	The hospital or surgery center	$5,370	$2,344 to $9,772

How much rates vary

Facilitymedian $5,370 · 10th to 90th $692 to $15,488Professionalmedian $661 · 10th to 90th $417 to $1,698

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	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier Global Typical Low $758.58 Median $4,073.80 Typical High $10,964.78	Facility	Global	$758.58	$4,073.80	$10,964.78
BCBS Setting Facility Modifier Global Typical Low $3,162.28 Median $8,511.38 Typical High $20,892.96	Facility	Global	$3,162.28	$8,511.38	$20,892.96
Cigna Setting Facility Modifier Global Typical Low $630.96 Median $1,230.27 Typical High $4,073.80	Facility	Global	$630.96	$1,230.27	$4,073.80
United Setting Facility Modifier Global Typical Low $1,862.09 Median $5,754.40 Typical High $14,791.08	Facility	Global	$1,862.09	$5,754.40	$14,791.08

What it costs in each state

The same service costs 12.9 times more in Wisconsin than in Maryland. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility fee

WI $14,804MD $1,147

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.