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Open Biopsy of a Neck or Lower Back Vertebra

South Dakota 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?

$708

Typical facility fee. In South Dakota, July 2026.

Insurers have agreed to pay about $708 for this service. Most negotiated rates run $575 to $851.

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 $724 · 10th to 90th $490 to $4,365Professionalmedian $708 · 10th to 90th $490 to $912
$500$1K$2K$5K$10Kfacility $724professional $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
$416.87
Median
$3,548.13
Typical High
$4,365.16
Medica
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$691.83
Typical High
$1,096.48
Midlands
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$954.99
Typical High
$954.99
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$707.95
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$14,791.08

Where South Dakota 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.

South Dakota· 47th of 50

$708

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.