Breast biopsy Cost by Hospital

Breast biopsy is a surgical procedure. Prices are from 1987 US hospitals across 52 states, from their machine-readable files.

$2,493median cash price · 1987 hospitals, 52 statestypically $954–$5,501 depending on the hospital
≈ 5.2× Medicare · High vs MedicareFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$4,639
Cash / self-pay
$2,493
Insurer-negotiated
$2,031
Medicare pays
$478
$954$5,501
Median cash $2,493  ·  Medicare $478  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $2,493 — 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 $4,639 list price could save about $2,146 (46%).

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 —
Northwest Florida Community Hospital Chipley, FL $389 $325 ★ 2/5 — —
Harney District Hospital Burns, OR $395 $437 — 94 min —
Ochsner Medical Center Acute New Orleans, LA $398 $1,539 ★ 4/5 174 min —
Bassett Healthcare Cooperstown, NY $400 $679 ★ 2/5 199 min —
Holzer Medical Center Gallipolis, OH $411 $1,563 ★ 4/5 139 min —
Holzer Medical Center Jackson Jackson, OH $411 $608 ★ 3/5 137 min —
University Medical Center Las Vegas, NV $416 $520 ★ 2/5 238 min —
UPMC Cole Coudersport, PA $421 $559 ★ 4/5 147 min —
East Jefferson General Hospital Metairie, LA $422 $8,798 ★ 2/5 157 min —
Kern Medical Center Bakersfield, CA $425 $651 ★ 1/5 306 min —
Red Bud Regional Hospital Red Bud, IL $433 $890 ★ 4/5 122 min —
Johnson Memorial Hospital Franklin, IN $433 $1,618 ★ 5/5 139 min —
Wellmont Bristol Regional Medical Center Bristol, TN $433 $1,645 ★ 2/5 196 min —
Wellmont Holston Valley Medical Center Kingsport, TN $433 $1,645 ★ 2/5 204 min —
Sycamore Shoals Hospital Elizabethton, TN $433 $1,573 ★ 2/5 142 min —
Hawkins County Memorial Hospital Rogersville, TN $433 $1,573 — 113 min —
Greeneville Community Hospital Greeneville, TN $433 $1,618 ★ 2/5 154 min —
Johnson City Medical Center Johnson City, TN $433 $1,618 ★ 1/5 211 min —
Indian Path Community Hospital Kingsport, TN $433 $1,588 — 136 min —
Franklin Woods Community Hospital Johnson City, TN $433 $1,575 ★ 3/5 178 min —
Johnson County Community Hospital Mountain City, TN $433 $1,618 — 131 min —
Russell County Hospital Lebanon, VA $433 $1,692 ★ 4/5 130 min —
Smyth County Community Hospital Marion, VA $433 $1,692 ★ 3/5 141 min —
Johnston Memorial Hospital Abingdon, VA $433 $1,688 ★ 3/5 192 min —

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 October 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: $2,493; Medicare pays $478.

InsurerHospitalsNegotiated median
Independent Health 20
$163
$101 – $1,971
Univera 15
$164
$127 – $542
Medicaid 282
$342
$62 – $1,753
Amerigroup 151
$511
$486 – $1,745
AmeriHealth 203
$1,176
$147 – $4,790
Bright Health 49
$1,257
$870 – $3,680
Geisinger 67
$1,453
$201 – $5,710
Sanford Health Plan 50
$1,474
$162 – $2,869
Tricare / VA 310
$1,501
$139 – $3,742
Molina Healthcare 518
$1,502
$226 – $3,036
Medicare 444
$1,506
$74 – $2,332
UCare 59
$1,563
$149 – $2,951
Devoted Health 144
$1,568
$583 – $1,952
UPMC Health Plan 89
$1,572
$194 – $6,708
Centene / Ambetter 671
$1,575
$298 – $3,015
Priority Health 56
$1,587
$208 – $5,494
HealthPartners 197
$1,635
$210 – $3,969
Security Health Plan 49
$1,661
$342 – $4,867
Highmark 120
$1,687
$183 – $5,945
Medica 162
$1,688
$322 – $4,058
Humana 865
$1,689
$342 – $4,690
Harvard Pilgrim 40
$1,691
$386 – $5,425
UnitedHealthcare 1330
$1,993
$392 – $5,279
Kaiser Permanente 210
$2,026
$172 – $5,523
Workers' Comp / No-Fault 109
$2,123
$857 – $5,280
Blue Cross Blue Shield 1102
$2,181
$342 – $6,585
SelectHealth 43
$2,230
$469 – $5,307
Health Net 244
$2,282
$416 – $5,921
Aetna 1233
$2,334
$461 – $6,101
Healthcare Highways 42
$2,434
$2,129 – $3,160
Anthem 509
$2,457
$322 – $7,137
Coventry 124
$2,630
$447 – $5,717
AvMed 54
$2,789
$514 – $8,971
MVP Health Care 78
$2,886
$322 – $5,575
EmblemHealth 72
$3,007
$679 – $13,030
Oscar Health 208
$3,611
$1,360 – $4,723
MultiPlan / PHCS network 679
$3,626
$1,127 – $7,159
Cigna 1034
$3,965
$1,322 – $8,944

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
New Mexico$1,041
Arizona$1,050
Tennessee$1,081
Louisiana$1,168
Maryland$1,187
Vermont$1,318

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 1987 US hospitals across 52 states, the typical (median) cash price is $2,493, versus a chargemaster (list) price around $4,639, a median insurer-negotiated rate of $2,031, a Medicare rate of about $478. Most cash prices fall between $954 and $5,501 — 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 1987 US hospitals is $2,493. Most hospitals fall between $954 and $5,501. 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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