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Open Biopsy of a Neck or Lower Back Vertebra

Virginia 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?

$3,236

Typical facility fee. In Virginia, July 2026.

Insurers have agreed to pay about $3,236 for this service. Most negotiated rates run $537 to $7,079.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3,236 · 10th to 90th $447 to $10,965Professionalmedian $562 · 10th to 90th $398 to $813
$500$1K$2K$5K$10Kfacility $3,236professional $562

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
$489.78
Median
$5,011.87
Typical High
$8,912.51
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$9,772.37
Median
$13,182.57
Typical High
$15,488.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$645.65
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$512.86
Typical High
$616.60
Medcost
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$707.95
Typical High
$1,000.00
Medcost
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$549.54
Typical High
$831.76
Sentara
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$549.54
Typical High
$7,943.28
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$8,912.51
Typical High
$17,782.79

Where Virginia 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.

Virginia· 33rd of 50

$3,236

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.