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Biopsy of a Toe Joint

Massachusetts rates for HCPCS 28054

This procedure opens a joint in a toe, between two of the toe bones, through a small incision to obtain a tissue sample from inside the joint. It is used to investigate unexplained swelling, pain, or a suspected growth in that area when other testing has not been conclusive. The joint is closed afterward and the toe is typically protected while it heals.

Rates data updated July 2026.

How much does Biopsy of a Toe Joint cost?

$437

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $437 for this service. The price depends on where it is billed: about $437 from a physician practice, and about $1,778 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$437$295 to $646
FacilityA hospital or hospital-owned outpatient department$1,778$355 to $3,311

How much rates vary

Facilitymedian $1,778 · 10th to 90th $282 to $5,129Professionalmedian $437 · 10th to 90th $240 to $933
$200$500$1K$2K$5K$10K$20Kfacility $1,778professional $437

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
$363.08
Median
$2,754.23
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$363.08
Typical High
$758.58
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$4,897.79
Typical High
$28,840.32
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$457.09
Typical High
$1,148.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$645.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$478.63
Typical High
$912.01
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$331.13
Typical High
$3,467.37
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$501.19
Typical High
$707.95
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$4,265.80
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$467.74
Typical High
$912.01
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$4,897.79
Typical High
$28,840.32
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$457.09
Typical High
$1,148.15
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$4,265.80
Typical High
$9,772.37
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$501.19
Typical High
$977.24

Where Massachusetts sits

The same service costs 5.9 times more in California 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.

Massachusetts· 17th of 51

$437

CA $1,905WV $324

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.