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Open Biopsy of a Neck or Lower Back Vertebra

California 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?

$7,413

Typical facility fee. In California, July 2026.

Insurers have agreed to pay about $7,413 for this service. Most negotiated rates run $4,898 to $10,715.

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.

How much rates vary

Facilitymedian $7,413 · 10th to 90th $2,754 to $16,596Professionalmedian $525 · 10th to 90th $380 to $977
$100.0$1.0K$10.0Kfacility $7,413professional $525

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
$2,884.03
Median
$7,079.46
Typical High
$19,054.61
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,570.88
Median
$8,128.31
Typical High
$15,848.93
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$5,128.61
Typical High
$10,964.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$2,691.53
Typical High
$6,918.31
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$478.63
Typical High
$645.65
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$524.81
Typical High
$977.24
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$20,892.96
Median
$20,892.96
Typical High
$45,708.82
Providence
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$562.34
Typical High
$954.99
United
Setting
Facility
Modifier
Global
Typical Low
$5,248.07
Median
$10,000.00
Typical High
$20,892.96

Where California sits

The same service costs 53.7 times more in Indiana than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

California $7,413 · 8th of 50
IN $22,387WV $417

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.