Biopsy Cost

Last Updated on December 22, 2022
Written by CPA Alec Pow | Content Reviewed by CFA Alexander Popinker

A biopsy is the surgical removal or aspiration of a fragment of tissue to be studied under a microscope to help establish the diagnosis.

Most often, this medical procedure is used to determine if the patient is suffering from a type of cancer, but it can also be used to diagnose another disease, such as infertility. Usually, the doctor pushes a patient towards this option when he finds an abnormality in the tissue and wants to know more about the causes.

Most of these interventions are painless and low risk. Depending on the specifics of the situation, the removed area may be a piece of skin, tissue, organ, or tumor.

How Much Does a Biopsy Cost?

If you don’t have a health insurance plan, be prepared to pay anywhere between $155 and $1,100 for a skin biopsy. The costs will be higher for a surgical biopsy, while for a needle biopsy done in a doctor’s office the prices should be lower.

Patients without health insurance will have to pay anywhere between $1,100 and $5,100 for a breast biopsy. At the higher end of the range will be the surgical biopsies, while the ones done in a doctor’s office will be at the lower end.

Patients without health insurance will have to pay anywhere between $2,100 and $7,100, or even more for a liver biopsy.

Also, patients without health insurance will have to pay anywhere between $3,100 and $10,500 for a kidney biopsy.

A biopsy is a type of medical procedure that can be ordered by your doctor and is almost always covered by health insurance. Biopsies are necessary in some cases when doctors want to determine what’s wrong with your health.

Patients who have health insurance will have to pay out of their pockets, in form of coinsurance or copay, anywhere between 10% and 40% of the total cost of the procedure.

Biopsy details

Biopsies differ quite a bit from each other, depending on the procedure used and the organ under investigation. However, some specific steps can be taken in this treatment:

Patient preparation. The patient will be anesthetized locally or generally (less often), then placed in a position to facilitate the extraction of the sample.

The biopsy itself. After the anesthetic has taken effect, the actual procedure takes place. This may take a few minutes or even an hour, while the results will be ready in 2 to 21 days. The patient’s recovery is often rapid and does not require hospitalization.

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Sample preparation. The samples are usually kept in a mixture of water and formaldehyde, in containers with the patient’s data (name, place on the body where the sample was taken, etc.).

Analysis of evidence. After being treated with certain dyes, the samples are analyzed under a microscope, with a thorough look at the size and shape of the cells/cell nucleus, as well as their arrangement.

The results help the doctor determine if the cells are cancerous. If the cells are cancerous, the results of the biopsy may indicate where the cancer first occurred – the type of cancer. A biopsy also helps determine how aggressive the cancer is and helps with further treatment preparation.

After establishing the diagnosis, the pathologist creates an anatomical-pathological report based on what is observed under the microscope. The report is very technical, using terms that are significant to other pathologists and doctors. In general, the pathologist describes the types of cells, how they are arranged, whether abnormal cells are present, and so on.

What are the extra costs?

The cost could increase if imaging technology like ultrasound is used in order to guide the biopsy.

Important things to consider

Certification by the American Board of Medical Specialties is a requirement for all specialists involved in performing this procedure.

Depending on the body part that has to be evaluated and the type of the need biopsy, a primary care physician will make a referral to a surgeon, a radiologist, or another specialist for a biopsy.

For instance, a dermatologist will perform a skin biopsy, a breast biopsy is done by a gynecologist, a bone marrow biopsy is done by a hematologist. Also, a gastroenterologist will perform a liver or GI tract biopsy and a pulmonologist will perform a lung biopsy, while a kidney biopsy will be performed by a urologist.

In some cases, the amount of tissue obtained from a needle biopsy may not be enough and another biopsy may be needed. If the diagnosis remains uncertain after a technically successful procedure, a surgical biopsy may be required.

Any medical procedure that involves cutting the skin carries the risk of infection or the risk of bleeding. However, because the incision is small, especially with needle biopsies, the risk is much lower for the patient.

How can I save money?

Cash paying or uninsured patients may be able to save around 10% or even more of the total cost as there are hospitals that offer such discounts.