unfortunately there is no standard charge. however there are some price transparency tools that can help give you an idea. if you get insurance at work check to see if your employer offers one. your insurer may also have a pricing tool. and then there are sites such as fairhealthconsumer. org healthbluebook. com and newchoicehealth. com. these generally offer you pricing information based on past insurance claims submitted in your area. hospitals are contracted with insurance companys. hospitals can charge whatever they want. but insurances tell the hospital "per contract" what the hospital is allowed to charge. then the hospital does the contractual "adjustment" and writes off the difference. i. e. : bx costs $20 000. insurance says no contracted rate is $4 000. hospital writes off $16 000 and bills insurance the $4000. every insurance has a contracted rate for the procedure. again the insurance tells the hospital what it's allowed to charge. one insurance says hospital can bill $4000 another says contracted rate is $5000 another says contracted rate is $3000. so it all really depends on what insurance policy you have and what your insurance states the hospital can charge. bc al allowable is $909. 93 and medicare allowable is $ 606. 62
what is the standard charge for cpt code 19081. i had a stereotactic needle biopsy of a breast (cpt code 19081) and the provider billed the insurance company $6 000. this seems really exhorbitant for a simple needle biopsy. i've been attempting to find out if this is a realistic charge for this procedure.