Biopsy of breast and placement of locating device using x-ray with needle, first growth
Medicare pricing data for 7,926 providers across 52 states
This procedure has a 6.1x markup — hospitals charge $1,646 but Medicare allows only $270.63. Uninsured patients may face bills 6.1 times higher than what insurance negotiates. Prices vary significantly by location — from $158 in Vermont to $456 in Maryland. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Biopsy of breast and placement of locating device using x-ray with needle, first growth (HCPCS code 19081) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $270.63, but hospitals typically charge $1,646 — a 6.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $270.63, your out-of-pocket cost would be approximately $54.13. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.1x more than what Medicare allows for this procedure. Medicare actually pays $210.47 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Maryland | $456 | $1,695 | 149 | 1,447 | +68.5% |
| Arizona | $400 | $2,042 | 115 | 1,007 | +47.7% |
| Wyoming | $392 | $2,223 | 21 | 148 | +44.9% |
| New York | $383 | $3,123 | 498 | 4,014 | +41.4% |
| Nevada | $362 | $1,807 | 44 | 321 | +33.8% |
| New Mexico | $351 | $2,539 | 39 | 191 | +29.6% |
| District of Columbia | $343 | $1,974 | 46 | 448 | +26.8% |
| New Jersey | $333 | $2,035 | 211 | 2,040 | +22.9% |
| California | $323 | $1,774 | 664 | 4,936 | +19.4% |
| Washington | $309 | $1,438 | 222 | 1,384 | +14.3% |
| Florida | $306 | $1,819 | 503 | 4,207 | +13.2% |
| North Carolina | $303 | $1,843 | 324 | 2,559 | +12.0% |
| Nebraska | $301 | $1,910 | 80 | 539 | +11.1% |
| Alaska | $300 | $3,120 | 22 | 135 | +10.9% |
| Oregon | $297 | $1,216 | 91 | 523 | +9.6% |
| Colorado | $296 | $2,732 | 124 | 834 | +9.4% |
| Puerto Rico | $292 | $411 | 18 | 47 | +7.8% |
| Kansas | $290 | $820 | 101 | 469 | +7.1% |
| Hawaii | $287 | $1,341 | 25 | 135 | +5.9% |
| Iowa | $286 | $1,936 | 105 | 674 | +5.7% |
| Virginia | $279 | $1,423 | 230 | 1,959 | +3.0% |
| Minnesota | $271 | $1,609 | 169 | 708 | +0.2% |
| New Hampshire | $268 | $1,844 | 65 | 293 | -1.0% |
| Arkansas | $263 | $1,236 | 57 | 538 | -2.8% |
| Connecticut | $262 | $1,512 | 137 | 764 | -3.1% |
| Delaware | $254 | $1,323 | 19 | 270 | -6.0% |
| Texas | $247 | $1,758 | 448 | 2,836 | -8.6% |
| Rhode Island | $243 | $1,406 | 37 | 381 | -10.4% |
| Tennessee | $240 | $1,350 | 205 | 1,275 | -11.2% |
| Wisconsin | $230 | $2,876 | 228 | 1,039 | -14.9% |
| Illinois | $216 | $1,267 | 335 | 2,296 | -20.3% |
| Georgia | $214 | $1,475 | 241 | 1,402 | -20.8% |
| Pennsylvania | $213 | $1,239 | 351 | 2,548 | -21.3% |
| Montana | $208 | $981 | 36 | 209 | -23.0% |
| Massachusetts | $208 | $1,003 | 221 | 1,921 | -23.1% |
| North Dakota | $205 | $1,445 | 27 | 157 | -24.4% |
| Mississippi | $202 | $1,293 | 73 | 426 | -25.2% |
| Utah | $198 | $729 | 53 | 285 | -26.9% |
| Indiana | $196 | $1,169 | 186 | 1,399 | -27.4% |
| Michigan | $196 | $849 | 249 | 1,726 | -27.6% |
| Maine | $188 | $707 | 40 | 194 | -30.4% |
| South Dakota | $184 | $485 | 28 | 289 | -32.0% |
| Missouri | $180 | $1,124 | 191 | 1,430 | -33.6% |
| Idaho | $180 | $1,301 | 45 | 217 | -33.7% |
| South Carolina | $177 | $1,098 | 120 | 1,066 | -34.7% |
| Louisiana | $175 | $1,326 | 99 | 598 | -35.4% |
| Ohio | $171 | $1,301 | 278 | 1,950 | -36.7% |
| Alabama | $171 | $1,104 | 107 | 554 | -37.0% |
| Kentucky | $169 | $745 | 104 | 772 | -37.4% |
| Oklahoma | $168 | $980 | 67 | 455 | -37.9% |
| West Virginia | $159 | $1,175 | 52 | 250 | -41.4% |
| Vermont | $158 | $1,815 | 18 | 112 | -41.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber