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Reviewed by John Caruso, FSA, MAAA • Data last updated

Breast Biopsy Cost in Pennsylvania (2026): Average Prices & What You'll Pay

What does a breast biopsy cost in Pennsylvania?

You could pay $515 or $1,562 for the same breast biopsy in Pennsylvania - depending entirely on which facility you choose. The median cash price across 137 reporting hospitals is $859. This data comes directly from hospital price transparency files published under federal law. The sections below break this down by coverage and by insurer.

Once you have a bill or an appointment on the calendar, CostKits can help you keep it all organized.

Where breast biopsy costs vary in Pennsylvania

Pins show hospitals with price-transparency data (colored by vs. state average) and nearby outpatient clinics and other facilities (colored by type). Click any pin for facility name and estimated cost range.

Hospital (below avg) Hospital (above avg) Click a pin for details.

26+ people checked prices near them this month.

What you pay for a breast biopsy depends on where you go and what is billed separately. Most patients find out after.

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Cheapest Breast Biopsy Providers in Pennsylvania

Based on declared cash/self-pay prices from CMS hospital price transparency files.

# Facility City Price vs median ($859)
1 Abington Memorial Hospital Abington, PA $260 $599 below
2 Lansdale Hospital Corp Lansdale, PA $260 $599 below
3 Thomas Jefferson University Hospital, Inc. Philadelphia, PA $265 $594 below
4 ROBERT PACKER HOSPITAL Doing Business As: ROBERT PACKER HOSPITAL, TOWANDA CAMPUS Towanda, PA $268 $591 below
5 TROY COMMUNITY HOSPITAL INCORPORATED Troy, PA $268 $591 below
6 ROBERT PACKER HOSPITAL Sayre, PA $268 $591 below
7 UPMC Cole Coudersport, PA $270 $589 below
8 Geisinger Wyoming Valley Wilkes-Barre, PA $280 $579 below

Prices are declared self-pay rates. Contact each facility for a formal quote before scheduling.

Before you book: three questions that change the price

  1. Is this the self-pay price, and does it include the doctor, anesthesia and any lab or pathology? Those are often billed separately.
  2. Can you give me the price in writing, with the billing codes it covers?
  3. What happens to the price if something extra is needed during the procedure?

Estimate your out-of-pocket cost →  ·  When the bills arrive, we check them for errors →

Quick take

  • Abington Memorial Hospital is the lowest-cost option at $260 - $599 below the median posted price ($859), just by choosing where you go.
  • Ask for the cash price if your deductible isn't met - the median cash price here is $864, and it's often lower than what insurance pays before your deductible is satisfied.
  • Doctor offices and independent clinics may charge differently from hospitals for the same service and may not appear in this hospital-only dataset. Ask your doctor whether another site is an option.
Breast biopsy prices by coverage in Pennsylvania, October 2026
CoverageHospitals with a rateTypical rangeMedian
Medicare (national rate)—$1,687 to $1,687$1,687
With insurance (commercial, average)119$960 to $3,426$1,934
Without insurance (cash price)142$260 to $2,613$864
Highmark Blue Cross Blue Shield110$173 to $3,547$1,486
Aetna101$457 to $4,738$2,544
Cigna96$296 to $5,200$2,217
UnitedHealthcare89$256 to $4,246$1,736

Rates are negotiated allowed amounts and cash prices from hospital price-transparency files (October 2026), shown at each hospital’s lowest-priced typical billing code for this procedure. Facility fees only. The typical range is the middle 80% of hospitals, not a quote for your visit.

How much does a breast biopsy cost with Medicare in Pennsylvania?

Medicare's national hospital outpatient payment for breast biopsy is about $1,687 to $1,687 (typically near $1,687). After the $257 Part B deductible, you generally pay 20% of the Medicare-approved amount, about $337 on a $1,687 payment, with no out-of-pocket cap unless you have supplemental coverage or a Medicare Advantage plan.

Doctor, anesthesia and pathology fees are billed separately. Medicare rates are national CMS amounts, adjusted slightly by local wage levels.

How much does a breast biopsy cost with insurance in Pennsylvania?

Across 119 Pennsylvania hospitals, the negotiated rates commercial insurers pay for breast biopsy average $960 to $3,426 per hospital, with a median near $1,934. That is the amount your plan and you pay the hospital together; you owe your deductible, then coinsurance, up to your out-of-pocket maximum.

Each hospital’s figure is the average of the commercial insurers it lists. Medicare, Medicare Advantage and Medicaid rates are excluded.

How much does a breast biopsy cost without insurance in Pennsylvania?

Cash (self-pay) prices for breast biopsy at 142 Pennsylvania hospitals range from $260 to $2,613, with a median of $864. Ask for the cash or self-pay price and for any financial-assistance discount before you book; both can be lower than the posted price.

Cash prices are the hospital’s published discounted rate for patients paying without insurance.

How much does a breast biopsy cost with Highmark Blue Cross Blue Shield in Pennsylvania?

Highmark Blue Cross Blue Shield negotiated rates for breast biopsy at 110 Pennsylvania hospitals range from $173 to $3,547, with a median near $1,486. Your own cost depends on your plan’s deductible and coinsurance, and on whether the hospital is in your network.

Includes Blue Cross and Blue Shield and Anthem plans listed by each hospital.

How much does a breast biopsy cost with Aetna in Pennsylvania?

Aetna negotiated rates for breast biopsy at 101 Pennsylvania hospitals range from $457 to $4,738, with a median near $2,544. If a hospital is out of network for your Aetna plan, you may owe more than the negotiated rate, so check the network first.

How much does a breast biopsy cost with Cigna in Pennsylvania?

Cigna negotiated rates for breast biopsy at 96 Pennsylvania hospitals range from $296 to $5,200, with a median near $2,217. If a hospital is out of network for your Cigna plan, you may owe more than the negotiated rate, so check the network first.

How much does a breast biopsy cost with UnitedHealthcare in Pennsylvania?

UnitedHealthcare negotiated rates for breast biopsy at 89 Pennsylvania hospitals range from $256 to $4,246, with a median near $1,736. If a hospital is out of network for your UnitedHealthcare plan, you may owe more than the negotiated rate, so check the network first.

How where you go changes what you pay for breast biopsy

The same breast biopsy bundles different services depending on the setting - facility fee, surgeon fee, and anesthesia each arrive as separate bills. Estimated ranges below reflect the typical full bundled cost, including all expected charges.

Hospital Outpatient
$197–$6,427
  • Facility fee $98–$5,731
  • Professional fee $99–$696

Estimated from CMS fee schedules + commercial rate multipliers

Hospital Inpatient
$356–$6,427
  • Facility fee $257–$5,731
  • Professional fee $99–$696

Estimated from CMS fee schedules + commercial rate multipliers

Pennsylvania has a highly fragmented hospital market - Penn Medicine, Jefferson Health, Temple Health, and Tower Health compete in Philadelphia; UPMC and Highmark/Allegheny Health Network are engaged in one of the country's most litigated payer-provider disputes in Pittsburgh. The UPMC vs. Highmark conflict has directly affected patients' ability to use their insurance at in-network facilities. Rural Pennsylvania prices are substantially lower than the two major metro markets.

Received a bill? Check it for errors → Estimate YOUR cost before you go → Managing more than one bill? See the family tracker →

Why prices vary - and what it means for your coverage

A small number of hospitals (5) report prices above $3,590, including Nazareth Hospital at $5,731, which drives most of the overall spread - excluding them, most facilities cluster in a much tighter band. Setting matters too: the median outpatient price is $748 versus $978 inpatient (about 1.3× more), so where a procedure happens often matters more than which hospital you pick.

What you pay out of pocket on top of this depends on your deductible, your plan's out-of-pocket maximum, and whether every provider involved is in-network - not just the facility.

Your situation Estimated out-of-pocket
Deductible not yet met ~$859
Deductible met - 20% coinsurance ~$172
Out-of-network provider $1,890+

Frequently asked questions: breast biopsy costs in Pennsylvania

How much does a breast biopsy cost in Pennsylvania?

The typical insurer-negotiated rate is $75, with most facilities between $61 and $146 (based on 137 hospitals reporting negotiated rates). Posted cash prices at the middle 80% of Pennsylvania hospitals run $260–$2,613; outlier facilities above and below that range are left out. What you pay depends on the facility, your insurance, and whether you have met your deductible.

Where is the cheapest place to get a breast biopsy in Pennsylvania?

Based on declared prices, the lowest posted price in our Pennsylvania data is Abington Memorial Hospital in Abington at about $260. By metro, Langhorne has the lowest median ($293).

Why is a breast biopsy so much cheaper at some Pennsylvania hospitals?

Typical prices vary about 2.4× (25th to 70th percentile of negotiated rates) because each hospital sets its own list price, cash discount, and insurer-negotiated rates. In Pennsylvania, the median cash (self-pay) price is $864 versus a median negotiated rate of $1,934 - cash is the lower number at many hospitals. Asking for the cash price as well as your insurer's negotiated rate is often the single biggest lever on what you pay.

How much will I actually pay out of pocket for a breast biopsy in Pennsylvania?

Your out-of-pocket cost depends on your deductible, coinsurance, out-of-pocket maximum, and whether the facility is in-network - not just the sticker price. If you have not met your deductible, you will typically pay the negotiated rate in full until you do. Use the CostKits cost forecaster to estimate your specific out-of-pocket amount before you go.

Before you book

Other procedures in Pennsylvania

Breast Biopsy, elsewhere

CostKits compiles hospital price transparency data to help families make informed decisions. Track and manage your healthcare costs (free account).

Other Procedure Costs in Pennsylvania

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Emergency care

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About the Author

John Caruso, FSA, MAAA

Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.

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Published October 29, 2026 · Updated October 29, 2026

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