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Open Biopsy of a Neck or Lower Back Vertebra

Pennsylvania 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.

Facilitymedian $4,365 · 10th–90th $1,047$8,3180%5%10%10th90th$4,365$500.0$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$4,786.30
Typical High
$8,317.64
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$6,165.95
Typical High
$57,543.99
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$3,630.78
Typical High
$8,317.64
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$478.63
Typical High
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$5,011.87
Typical High
$23,442.29