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Open Biopsy of a Neck or Lower Back Vertebra

North Carolina 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?

$1,000

Typical facility fee. In North Carolina, July 2026.

Insurers have agreed to pay about $1,000 for this service. Most negotiated rates run $537 to $5,248.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1,000 · 10th to 90th $407 to $8,710Professionalmedian $708 · 10th to 90th $708 to $1,000
$500.0$1.0K$2.0K$5.0K$10.0K$20.0K$50.0Kfacility $1,000professional $708

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
$407.38
Median
$1,584.89
Typical High
$8,709.64
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$2,511.89
Typical High
$2,511.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$724.44
Typical High
$6,309.57
Medcost
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$1,000.00
Medcost
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$562.34
Typical High
$891.25
United
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$8,709.64
Typical High
$14,791.08
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$20,892.96
Median
$20,892.96
Typical High
$45,708.82

Where North Carolina 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.

North Carolina $1,000 · 43rd 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.