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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.

Facilitymedian $708 · 10th–90th $407$4,3650%20%10th90th$708Professionalmedian $708 · 10th–90th $490$9120%10%20%10th90th$708$500.0$1.0K$2.0K$5.0K$10.0K

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
$407.38
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