How Much Does a Breast Biopsy Cost in 2026?

Yes. When a doctor orders a biopsy to work up an abnormal mammogram, ultrasound, or a lump, it is medically necessary and covered by essentially all commercial plans, Medicare, and Medicaid. But a biopsy is diagnostic, not preventive, so unlike a screening mammogram it is not free: you owe your deductible plus coinsurance, usually a few hundred dollars up to about $2,000, capped by your plan's annual out-of-pocket maximum. The pathology lab that reads the sample is billed separately.

A screening mammogram is covered as free preventive care with no cost-sharing. The moment something looks abnormal and your doctor orders follow-up diagnostic imaging or a biopsy, that care is diagnostic, not preventive, so it is billed to your deductible and coinsurance. This surprises many people who assumed the whole workup would be free. The biopsy, the imaging guidance, and the pathology reading can each appear as separate charges. Here is a fuller explanation of when a mammogram is billed as diagnostic.

A fine-needle aspiration (FNA, CPT 19100) done in an office is the least expensive because it uses a thin needle and little or no imaging equipment. An ultrasound-guided core needle biopsy (CPT 19083) is the next most common and moderately priced. Stereotactic (mammogram-guided) core biopsy (CPT 19081) costs more, and an MRI-guided biopsy (CPT 19085) is the most expensive because MRI time is costly. Your doctor chooses the method based on how the area is best seen, not on price alone.

The tissue removed during a breast biopsy is sent to a pathology lab, where a pathologist examines it and writes a report. That professional and lab work is billed separately from the biopsy procedure itself, so a single biopsy commonly produces two or more bills: one for the procedure and imaging guidance, and one for pathology. Confirm the pathology lab is in-network to avoid a surprise out-of-network charge.

Under the 2026 Medicare Physician Fee Schedule, the physician fee in a non-facility setting (an office or imaging center) is about $163 for a fine-needle aspiration (CPT 19100), about $476 for an ultrasound-guided core needle biopsy (CPT 19083), about $478 for a stereotactic core biopsy (CPT 19081), and about $719 for an MRI-guided biopsy (CPT 19085). In a hospital outpatient department the professional fee is lower and the facility bills its portion separately. You generally owe about 20% coinsurance after the Part B deductible unless a Medigap plan covers it, and pathology is billed separately.