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Open Biopsy of a Neck or Lower Back Vertebra

New York 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?

$6,166

Typical facility fee. In New York, July 2026.

Insurers have agreed to pay about $6,166 for this service. Most negotiated rates run $3,162 to $11,220.

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 $6,166 · 10th to 90th $646 to $14,454
$500.0$1.0K$2.0K$5.0K$10.0K$20.0K$50.0Kfacility $6,166

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
$524.81
Median
$4,570.88
Typical High
$10,000.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$11,220.18
Typical High
$17,782.79
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$1,995.26
Typical High
$8,912.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$1,862.09
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$645.65
Typical High
$1,659.59
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$50,118.72
Typical High
$75,857.76
United
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$4,897.79
Typical High
$11,748.98
Univera
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$501.19
Typical High
$1,905.46

Where New York 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.

New York $6,166 · 12th 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.