Biopsy Cost?

My US guided biopsy of two spots on my breast was $6500 and that didn't include pathology or the doctor (just surgical center).  I was floored at the cost!  ETA:  That was the amount billed to my insurance.  The contractual amount they approve was well over $5000.

Kim

I am self-pay (no health insurance) and upon request all my doctors immediately gave me a discount averaging 40% on their normal fee for the procedures they did. Labs, however, usually will not give any "self-pay discount" unless you are 'financially qualified', in other words in a low-income/minimal-assets situation. Hospitals likewise, although they are more likely to negotiate some kind of discount (say 20%) if you offer to pay the reduced fee in full immediately instead of the higher fee via a monthly payment plan.

My BS did a needle biopsy of a lymph node, plus a core biopsy of 2 tumors, in her office early this year.  Her fee for the three biopsies (1 needle + 2 cores) was $1200 after giving me a substantial discount. The pathology lab charged $2100 for the various tests they did on the three biopsy samples (no discount given by them). The cost of the HER2 test only, which was done by a different lab, was $231 (no discount).

So I paid a total of around $3500 for everything connected with the three in-office biopsy samples.

The cost of the biopsies done in connection with my surgery (the sentinel node biopsies plus the biopsies of both removed breasts/tissues/tumors) a month later were higher, of course, because of the more extensive work involved.

Pat, don't hesitate to call the surgical center and ask to speak to someone regarding the possibility of a discount even though they already sent you the bill. Ask for office manager or the billing department manager. My anesthesiologist (who did not know at the time of surgery that I had no insurance) reduced his original billed fee by 45% after I called the office on receipt of the bill and asked if there could be a discount. The surgical assistant's office reduced their original fee by 80% (yes, eighty!) after I made several phone calls asking for a discount after getting their bill; that one took more perseverance but the end result was worth it! 

I'm just reviewing/paying medical bills at this very moment.  The cost for my ultrasound guided core biopsy was $6977 (the radiologist and pathologist billed separately). My balance isn't huge, so that's not the issue.  My issue is that I can't believe it costs that much --  the insurance company paid it, Ultimately, that's part of the reason health insurance is so expensive and the consumer pays in the end

On the positive side, they did my mammogram, and were concerned, moved immediately to the diagnostic ultrasound and were concerned, then immediately to the core biopsy, all the the same day. And pathology turned around the preliminary results within 24 hours.  The radiologist called me the following evening with the results.  He also gave me his cell phone number and called me over the weekend to see if I was OK.  (I think they were afraid I was going to jump off a rbidge or something drastic.)  They were amazing!  So maybe I shouldn't whine about the prices?

Here are the itemized charges:

• $1075 - Laboratory/Pathological (there was a separate bill from the pathologist, but I get that they had to make & process the slides)
• $1909 - Medical Surgical Supplies (WTF?  $2000 for the use of the gown, ultrasound gel, core "needle," several alcohol swabs and a large bandaid?)
• $1198 - Operating Room Services (another WTF - this was done in the regular ultrasound room by the radiologist (who bills separately & an ultrasound tech)
• $2194 - Other imaging services (I think this included the mammogram that I had earlier that day, plus diagnostic ultrasound)

I was scheduled for an ultrasound guided biopsy at a breast center. The cost was going to be $1900. I learned that I could save $700-$900 if I had it done at an imaging center instead. I've canceled my biopsy at the breast center and am awaiting my appointment at Simon Med. I will post again if the price is higher, but be sure to check your options before getting your biopsy done. Every location has a different contracted rate with each insurance they accept and they also have a different cash price if you do not go through insurance.

Biopsies do not have to be done at a hospital breast center. Some physicians can do them in the office and many outpatient imaging medical centers can do them as well.