Cost of a Mastectomy Visit
in Illinois
Reviewed by Momentary Medical Group West PC
Illinois healthcare costs run approximately 10% above the national average, particularly in the Chicago metropolitan area where most specialist care is concentrated. Mastectomy procedures typically range from $90 to $1,846, with a median cost of $740 based on negotiated insurance rates across 4,743 active providers statewide. Patients in Illinois have access to numerous qualified Mastectomy specialists, from major academic medical centers like Northwestern and University of Chicago to community hospitals throughout the state.
Average
$892
Median
$740
Lowest
$90
Highest
$1,846
Providers
4,743
9% below national average
Compare Similar Procedures
How does mastectomy compare to related procedures in Illinois?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $85 | $1,778 | $3,789 | 4,831 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $85 | $1,664 | $3,707 | 4,966 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $418 | $694 | $1,200 | 3,854 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $90 | $655 | $1,895 | 4,839 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $85 | $943 | $1,984 | 4,987 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $85 | $857 | $1,654 | 6,834 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $85 | $1,214 | $2,665 | 5,065 |
| Septoplasty Nasal septum repair | 30520 | $512 | $683 | $1,289 | 3,659 |
| Tonsillectomy Tonsillectomy, primary or secondary | 42820 | $253 | $339 | $596 | 3,648 |
| Inguinal Hernia Repair Inguinal hernia repair | 49505 | $90 | $707 | $1,569 | 4,730 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $372 | $594 | $1,070 | 3,849 |
Important: These are cost estimates only — not a quote and not medical advice.
The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 19301 — Mastectomy, partial / simple complete). They represent what a patient might pay without insurance.
Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.
This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.
Where this data comes from & what CPT 19301 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 19301 (Mastectomy, partial / simple complete), as mandated by the CMS Price Transparency Rule.
What CPT 19301 covers: the provider's professional fee for mastectomy. It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.
How to read this data
Negotiated Rate
The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.
P5, Median, P95
P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.
What this does not tell you
These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.
Top-Rated Hospitals in Illinois
These hospitals in Illinois are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
GALENA, IL
CARTHAGE, IL
GIBSON CITY, IL
MONMOUTH, IL
Hospital ratings are based on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey data published by CMS.
Why Mastectomy Visit Costs Vary Across Illinois
Healthcare costs in Illinois run about 10% above the national average, driven primarily by Chicago's high concentration of academic medical centers and elevated operating costs. The state's healthcare market is heavily concentrated in the northern metropolitan area, creating cost disparities between urban and rural regions.
Urban vs. Rural Provider Availability
Chicago and its suburbs house the majority of Illinois's mastectomy specialists, while downstate regions often have limited options requiring patient travel for care. Rural counties south of Springfield may have only one or two qualified breast surgeons, reducing price competition. This geographic concentration forces many patients to seek care in higher-cost urban markets or face lengthy wait times for local providers.
Facility Type and Overhead Costs
Major health systems like Northwestern Medicine, Advocate Aurora, and University of Chicago Medicine dominate the Illinois market with higher facility fees than independent practices. Hospital-based outpatient surgery departments typically charge 40-60% more than ambulatory surgery centers for the same procedures. Academic medical centers command premium pricing due to their teaching hospital status and specialized equipment investments.
Insurance Market Competition in Illinois
Blue Cross Blue Shield of Illinois maintains the largest market share, followed by UnitedHealthcare and Aetna, creating moderate competition in most regions. The Chicago metro area has the most insurer options, leading to more competitive negotiated rates with providers. Rural areas often have limited insurer participation, reducing competitive pressure on healthcare pricing and potentially increasing patient costs.
Physician Supply and Demand in Illinois
With 4,743 providers performing mastectomy procedures across Illinois, the state has adequate specialist supply in urban areas but significant shortages in rural regions. This geographic mismatch creates longer wait times and higher prices in underserved areas while maintaining competitive pricing in Chicago. The concentration of medical schools and residency programs in northern Illinois helps maintain physician supply in metropolitan markets.
Jayant Panwar
CEO, Momentary Labs · San Francisco, CA
Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.
The cost figures on this page reflect his ongoing work to make this data accessible to patients.
Frequently Asked Questions — Mastectomy Costs in Illinois
What is the average cost of a Mastectomy visit in Illinois without insurance?
Does Illinois Medicaid cover Mastectomy visits?
How do I find an affordable Mastectomy near me in Illinois?
What is the difference in cost between an initial consultation and a follow-up visit?
Can I use an HSA or FSA to pay for a Mastectomy visit in Illinois?
How does telemedicine affect the cost of seeing a Mastectomy in Illinois?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 19301)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $3,947 | $1,668 |
| 2 | Iowa Range: $85 – $3,021 | $1,499 |
| 3 | Rhode Island Range: $509 – $2,642 | $1,413 |
| 4 | Wyoming Range: $747 – $2,064 | $1,305 |
| 5 | Connecticut Range: $426 – $2,642 | $1,301 |
| 6 | South Dakota Range: $491 – $2,423 | $1,284 |
| 7 | Alaska Range: $85 – $2,902 | $1,275 |
| 8 | Georgia Range: $350 – $2,473 | $1,269 |
| 9 | Minnesota Range: $445 – $2,393 | $1,264 |
| 10 | Massachusetts Range: $350 – $2,408 | $1,249 |
| 11 | New York Range: $452 – $2,642 | $1,234 |
| 12 | Nebraska Range: $760 – $1,529 | $1,227 |
| 13 | Montana Range: $85 – $2,902 | $1,221 |
| 14 | Pennsylvania Range: $250 – $2,642 | $1,199 |
| 15 | Delaware Range: $95 – $2,642 | $1,147 |
| 16 | New Hampshire Range: $537 – $1,658 | $1,142 |
| 17 | Washington Range: $585 – $1,804 | $1,112 |
| 18 | Maine Range: $749 – $1,274 | $1,093 |
| 19 | North Dakota Range: $478 – $1,820 | $1,061 |
| 20 | District of Columbia Range: $434 – $1,611 | $1,037 |
| 21 | New Mexico Range: $560 – $1,525 | $1,008 |
| 22 | California Range: $85 – $1,972 | $1,006 |
| 23 | Utah Range: $85 – $1,449 | $966 |
| 24 | North Carolina Range: $346 – $1,713 | $963 |
| 25 | West Virginia Range: $366 – $1,695 | $946 |
| 26 | Vermont Range: $491 – $1,593 | $944 |
| 27 | Oregon Range: $85 – $1,746 | $922 |
| 28 | Indiana Range: $85 – $1,818 | $892 |
| 29 | Illinois Range: $90 – $1,846 | $892 |
| 30 | Michigan Range: $429 – $1,470 | $851 |
| 31 | Colorado Range: $85 – $1,561 | $841 |
| 32 | Hawaii Range: $85 – $1,475 | $827 |
| 33 | Oklahoma Range: $510 – $1,257 | $807 |
| 34 | Idaho Range: $85 – $1,484 | $803 |
| 35 | Kentucky Range: $85 – $1,529 | $783 |
| 36 | Tennessee Range: $371 – $1,198 | $777 |
| 37 | South Carolina Range: $318 – $1,315 | $776 |
| 38 | New Jersey Range: $314 – $1,446 | $773 |
| 39 | Florida Range: $85 – $1,536 | $770 |
| 40 | Kansas Range: $571 – $995 | $763 |
| 41 | Missouri Range: $516 – $946 | $762 |
| 42 | Alabama Range: $366 – $1,251 | $756 |
| 43 | Maryland Range: $346 – $1,292 | $755 |
| 44 | Virginia Range: $346 – $1,292 | $755 |
| 45 | Louisiana Range: $331 – $1,229 | $732 |
| 46 | Arizona Range: $525 – $1,108 | $728 |
| 47 | Texas Range: $85 – $1,341 | $716 |
| 48 | Mississippi Range: $447 – $1,086 | $715 |
| 49 | Ohio Range: $303 – $1,175 | $692 |
| 50 | Arkansas Range: $85 – $1,107 | $675 |
| 51 | Nevada Range: $300 – $1,022 | $610 |