go back

Open Biopsy of a Neck or Lower Back Vertebra

Illinois 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?

$1,862

Typical facility fee. In Illinois, July 2026.

Insurers have agreed to pay about $1,862 for this service. Most negotiated rates run $832 to $4,898.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2,138 · 10th to 90th $759 to $9,333Professionalmedian $759 · 10th to 90th $468 to $2,951
$200$500$1K$2K$5K$10K$20Kfacility $2,138professional $759

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
$676.08
Median
$1,862.09
Typical High
$7,762.47
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,786.30
Median
$10,232.93
Typical High
$12,589.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6,760.83
Median
$6,760.83
Typical High
$6,760.83
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$758.58
Typical High
$2,951.21
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$6,025.60
Typical High
$10,964.78

Where Illinois sits

The same service costs 53.7 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.

Illinois· 38th of 50

$1,862

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.