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Breast Biopsy, Excision or Other Procedures (without CC/MCC)

Pennsylvania rates for MS-DRG 585

Breast Biopsy, Local Excision and Other Breast Procedures without CC/MCC

Rates data updated July 2026.

How much does Breast Biopsy, Excision or Other Procedures (without CC/MCC) cost?

$28,840

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $28,840 for this service. Most negotiated rates run $19,055 to $35,481.

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 9 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $28,840 · 10th to 90th $15,136 to $40,738
$5K$10K$20K$50Kfacility $28,840

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
$15,848.93
Median
$28,840.32
Typical High
$40,738.03
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$15,135.61
Median
$28,183.83
Typical High
$44,668.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$15,848.93
Median
$30,902.95
Typical High
$43,651.58
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$33,884.42
Median
$33,884.42
Typical High
$41,686.94
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$14,125.38
Median
$32,359.37
Typical High
$39,810.72
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$36,307.81
Median
$54,954.09
Typical High
$75,857.76
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$17,378.01
Median
$28,840.32
Typical High
$40,738.03
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$14,454.40
Median
$16,595.87
Typical High
$18,620.87
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$25,118.86
Typical High
$44,668.36

Where Pennsylvania sits

The same service costs 3.3 times more in California than in New Mexico. 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.

Pennsylvania· 26th of 51

$28,840

CA $51,286NM $15,488

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.