Breast biopsy Cost by Hospital

Breast biopsy is a surgical procedure. Prices are from 1974 US hospitals across 52 states, from their machine-readable files.

$2,494median cash price · 1974 hospitals, 52 statestypically $940–$5,491 depending on the hospital
≈ 5.2× Medicare · High vs MedicareFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$4,572
Cash / self-pay
$2,494
Insurer-negotiated
$2,054
Medicare pays
$478
$940$5,491
Median cash $2,494  ·  Medicare $478  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

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%).

Estimate what you’ll pay
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Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
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.

InsurerHospitalsNegotiated median
Independent Health 20
$163
$101 – $1,971
Univera 15
$164
$127 – $542
Medicaid 279
$342
$62 – $1,753
Amerigroup 150
$511
$486 – $1,745
AmeriHealth 201
$1,176
$146 – $4,807
Bright Health 49
$1,257
$870 – $3,680
Geisinger 66
$1,453
$201 – $5,710
Sanford Health Plan 50
$1,474
$162 – $2,869
Tricare / VA 305
$1,501
$139 – $3,742
Molina Healthcare 515
$1,503
$226 – $3,036
Medicare 439
$1,506
$74 – $2,332
UCare 59
$1,563
$149 – $2,951
Centene / Ambetter 655
$1,568
$298 – $3,015
Devoted Health 142
$1,568
$510 – $1,952
Priority Health 57
$1,583
$208 – $5,494
UPMC Health Plan 88
$1,588
$278 – $6,708
HealthPartners 197
$1,636
$210 – $3,952
Security Health Plan 49
$1,661
$342 – $4,867
Highmark 114
$1,687
$183 – $5,945
Medica 162
$1,688
$322 – $4,058
Humana 854
$1,690
$350 – $4,690
Harvard Pilgrim 40
$1,691
$386 – $5,425
UnitedHealthcare 1306
$2,001
$374 – $5,279
Kaiser Permanente 208
$2,026
$171 – $5,523
Workers' Comp / No-Fault 108
$2,097
$857 – $5,282
Blue Cross Blue Shield 1098
$2,174
$342 – $6,585
SelectHealth 43
$2,230
$469 – $5,307
Health Net 242
$2,253
$416 – $5,933
Aetna 1210
$2,393
$484 – $6,158
Healthcare Highways 42
$2,434
$2,129 – $3,160
Anthem 493
$2,616
$262 – $7,499
Coventry 120
$2,644
$447 – $5,723
AvMed 54
$2,789
$514 – $8,971
MVP Health Care 77
$2,881
$322 – $5,407
MultiPlan / PHCS network 665
$3,609
$1,128 – $7,159
Oscar Health 194
$3,623
$1,377 – $4,723
EmblemHealth 59
$3,902
$1,747 – $18,105
Cigna 1011
$3,965
$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

StateMedian 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.

ClinicianSpecialtyLocationMedicare services
Ewa Bauer, M.D.Diagnostic RadiologyRedding, CA122
David Dorfman, MDDiagnostic RadiologyLindenhurst, NY109
Reeni Karavattuveetil, M.D.Diagnostic RadiologyBerwyn, IL94
Elizabeth Weinberg, M.D.General SurgeryWilmington, NC93
Sergio DromiDiagnostic RadiologyNaples, FL93
Mark HannaDiagnostic RadiologyWashington, DC93
Hedieh Saghari, MDDiagnostic RadiologyPhoenix, AZ93
Gregory Bebb, MDGeneral SurgeryWilmington, NC93
Joanna SadowskaDiagnostic RadiologyLargo, FL87
Jason Mckellop, M.D.Diagnostic RadiologyNew York, NY86
Azadeh Elmi, M.D.Diagnostic RadiologySan Diego, CA85
Barry Berson, M.D.Diagnostic RadiologyNew York, NY82

Browse doctors by specialty & city →

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?
The median cash (self-pay) price across 1974 US hospitals is $2,494. Most hospitals fall between $940 and $5,491. Prices vary widely between hospitals, so it pays to compare before you book.
Does Medicare cover Breast biopsy?
Yes — it is generally covered under Medicare Part B as an outpatient service (Medicare-approved amount about $478). After your Part B deductible you typically owe 20% coinsurance, unless a Medicare Advantage or Medigap plan covers it.
What does Medicare pay for Breast biopsy?
Medicare pays about $478. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Breast biopsy prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

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