Breast biopsy is a surgical procedure. Prices are from 1974 US hospitals across 52 states, from their machine-readable files.
Price comparison (median)
Typical cash price here is $2,494 — about 5.2× the Medicare rate ($478). High vs Medicare. A fair cash price is usually within ~2× Medicare ($957).
💡 Asking for the cash price instead of the $4,572 list price could save about $2,078 (45%).
Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.
Lowest cash prices
| Hospital | Location | Cash | Insurer | CMS rating | ER wait | Readmit |
|---|---|---|---|---|---|---|
| Seton Medical Center Harker Heights | Harker Heights, TX | $375 | $1,753 | ★ 4/5 | 174 min | 16.3% |
| Northwest Florida Community Hospital | Chipley, FL | $389 | $325 | ★ 2/5 | — | 14.3% |
| Harney District Hospital | Burns, OR | $395 | $437 | — | 93 min | 15.6% |
| Ochsner Medical Center Acute | New Orleans, LA | $398 | $1,539 | ★ 4/5 | 168 min | 16.2% |
| Bassett Healthcare | Cooperstown, NY | $400 | $679 | ★ 2/5 | 199 min | 15.6% |
| Holzer Medical Center | Gallipolis, OH | $411 | $1,563 | ★ 4/5 | 147 min | 14.9% |
| Holzer Medical Center Jackson | Jackson, OH | $411 | $608 | ★ 3/5 | 142 min | 15.0% |
| University Medical Center | Las Vegas, NV | $416 | $520 | ★ 2/5 | 240 min | 15.6% |
| UPMC Cole | Coudersport, PA | $421 | $559 | ★ 4/5 | 151 min | 14.9% |
| East Jefferson General Hospital | Metairie, LA | $422 | $8,798 | ★ 2/5 | 162 min | 15.3% |
| Kern Medical Center | Bakersfield, CA | $425 | $651 | ★ 1/5 | 293 min | 15.3% |
| Red Bud Regional Hospital | Red Bud, IL | $433 | $890 | ★ 4/5 | 121 min | 15.6% |
| Johnson Memorial Hospital | Franklin, IN | $433 | $1,618 | ★ 5/5 | 144 min | 14.9% |
| Wellmont Bristol Regional Medical Center | Bristol, TN | $433 | $1,645 | ★ 2/5 | 192 min | 15.8% |
| Wellmont Holston Valley Medical Center | Kingsport, TN | $433 | $1,645 | ★ 2/5 | 207 min | 14.8% |
| Sycamore Shoals Hospital | Elizabethton, TN | $433 | $1,573 | ★ 2/5 | 154 min | 15.0% |
| Hawkins County Memorial Hospital | Rogersville, TN | $433 | $1,573 | — | 112 min | 14.9% |
| Greeneville Community Hospital | Greeneville, TN | $433 | $1,618 | ★ 2/5 | 159 min | 16.0% |
| Johnson City Medical Center | Johnson City, TN | $433 | $1,618 | ★ 1/5 | 208 min | 15.5% |
| Indian Path Community Hospital | Kingsport, TN | $433 | $1,588 | — | 147 min | 14.5% |
| Franklin Woods Community Hospital | Johnson City, TN | $433 | $1,575 | ★ 3/5 | 176 min | 14.2% |
| Johnson County Community Hospital | Mountain City, TN | $433 | $1,618 | — | 126 min | — |
| Russell County Hospital | Lebanon, VA | $433 | $1,692 | ★ 4/5 | 117 min | 15.8% |
| Smyth County Community Hospital | Marion, VA | $433 | $1,692 | ★ 3/5 | 142 min | 14.7% |
| Johnston Memorial Hospital | Abingdon, VA | $433 | $1,688 | ★ 3/5 | 186 min | 15.1% |
CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated August 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.
What insurers pay for Breast biopsy
Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $2,494; Medicare pays $478.
| Insurer | Hospitals | Negotiated median |
|---|---|---|
| Independent Health | 20 |
$101 – $1,971 |
| Univera | 15 |
$127 – $542 |
| Medicaid | 279 |
$62 – $1,753 |
| Amerigroup | 150 |
$486 – $1,745 |
| AmeriHealth | 201 |
$146 – $4,807 |
| Bright Health | 49 |
$870 – $3,680 |
| Geisinger | 66 |
$201 – $5,710 |
| Sanford Health Plan | 50 |
$162 – $2,869 |
| Tricare / VA | 305 |
$139 – $3,742 |
| Molina Healthcare | 515 |
$226 – $3,036 |
| Medicare | 439 |
$74 – $2,332 |
| UCare | 59 |
$149 – $2,951 |
| Centene / Ambetter | 655 |
$298 – $3,015 |
| Devoted Health | 142 |
$510 – $1,952 |
| Priority Health | 57 |
$208 – $5,494 |
| UPMC Health Plan | 88 |
$278 – $6,708 |
| HealthPartners | 197 |
$210 – $3,952 |
| Security Health Plan | 49 |
$342 – $4,867 |
| Highmark | 114 |
$183 – $5,945 |
| Medica | 162 |
$322 – $4,058 |
| Humana | 854 |
$350 – $4,690 |
| Harvard Pilgrim | 40 |
$386 – $5,425 |
| UnitedHealthcare | 1306 |
$374 – $5,279 |
| Kaiser Permanente | 208 |
$171 – $5,523 |
| Workers' Comp / No-Fault | 108 |
$857 – $5,282 |
| Blue Cross Blue Shield | 1098 |
$342 – $6,585 |
| SelectHealth | 43 |
$469 – $5,307 |
| Health Net | 242 |
$416 – $5,933 |
| Aetna | 1210 |
$484 – $6,158 |
| Healthcare Highways | 42 |
$2,129 – $3,160 |
| Anthem | 493 |
$262 – $7,499 |
| Coventry | 120 |
$447 – $5,723 |
| AvMed | 54 |
$514 – $8,971 |
| MVP Health Care | 77 |
$322 – $5,407 |
| MultiPlan / PHCS network | 665 |
$1,128 – $7,159 |
| Oscar Health | 194 |
$1,377 – $4,723 |
| EmblemHealth | 59 |
$1,747 – $18,105 |
| Cigna | 1011 |
$1,365 – $9,036 |
Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.
Where it’s cheapest
| State | Median cash |
|---|---|
| Puerto Rico | $625 |
| New Mexico | $1,041 |
| Arizona | $1,050 |
| Tennessee | $1,097 |
| Louisiana | $1,168 |
| Maryland | $1,187 |
Prices by city
Prices by state
Doctors who perform this
Clinicians who reported the most Medicare volume for this service. This reflects Original Medicare activity only and is a volume signal, not a quality ranking.
| Clinician | Specialty | Location | Medicare services |
|---|---|---|---|
| Ewa Bauer, M.D. | Diagnostic Radiology | Redding, CA | 122 |
| David Dorfman, MD | Diagnostic Radiology | Lindenhurst, NY | 109 |
| Reeni Karavattuveetil, M.D. | Diagnostic Radiology | Berwyn, IL | 94 |
| Elizabeth Weinberg, M.D. | General Surgery | Wilmington, NC | 93 |
| Sergio Dromi | Diagnostic Radiology | Naples, FL | 93 |
| Mark Hanna | Diagnostic Radiology | Washington, DC | 93 |
| Hedieh Saghari, MD | Diagnostic Radiology | Phoenix, AZ | 93 |
| Gregory Bebb, MD | General Surgery | Wilmington, NC | 93 |
| Joanna Sadowska | Diagnostic Radiology | Largo, FL | 87 |
| Jason Mckellop, M.D. | Diagnostic Radiology | New York, NY | 86 |
| Azadeh Elmi, M.D. | Diagnostic Radiology | San Diego, CA | 85 |
| Barry Berson, M.D. | Diagnostic Radiology | New York, NY | 82 |
Does Medicare cover Breast biopsy?
Yes — Medicare generally covers Breast biopsy. It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $478. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $96 — unless a Medicare Advantage or supplemental (Medigap) plan covers it.
General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.
About these prices
Based on prices published by 1974 US hospitals across 52 states, the typical (median) cash price is $2,494, versus a chargemaster (list) price around $4,572, a median insurer-negotiated rate of $2,054, a Medicare rate of about $478. Most cash prices fall between $940 and $5,491 — a wide spread, which is exactly why comparing hospitals pays off.
How to save
- Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
- Compare several nearby hospitals; prices for the same service can differ severalfold.
- Request a written estimate and the billing code (CPT/DRG) before scheduling.
- Use the Medicare benchmark above to judge whether a quote is reasonable.
- If you are uninsured, ask about financial assistance or prompt-pay discounts.
Frequently asked questions
How much does Breast biopsy cost without insurance?
Does Medicare cover Breast biopsy?
What does Medicare pay for Breast biopsy?
Why do Breast biopsy prices vary between hospitals?
Is the cash price lower than using insurance?
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