Cost of a Mastectomy Visit
in Pennsylvania
Reviewed by Momentary Medical Group West PC
Pennsylvania's healthcare system, anchored by major academic medical centers in Philadelphia and Pittsburgh, serves patients across diverse urban and rural communities throughout the Commonwealth. Mastectomy visits typically cost between $249.88 and $2,641.73, with a median cost of $705.34 based on negotiated insurance rates. With 976 active Mastectomy providers across Pennsylvania, patients have access to specialists in both metropolitan areas and smaller communities statewide.
Average
$1,199
Median
$705
Lowest
$250
Highest
$2,642
Providers
976
22% above national average
Compare Similar Procedures
How does mastectomy compare to related procedures in Pennsylvania?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $909 | $1,551 | $6,051 | 916 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $80 | $1,379 | $6,060 | 1,270 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $85 | $618 | $2,135 | 984 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $366 | $623 | $2,410 | 933 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $98 | $709 | $1,984 | 1,021 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $80 | $632 | $1,669 | 1,389 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $85 | $975 | $3,201 | 983 |
| Septoplasty Nasal septum repair | 30520 | $434 | $719 | $2,160 | 910 |
| Tonsillectomy Tonsillectomy, primary or secondary | 42820 | $149 | $317 | $742 | 968 |
| Inguinal Hernia Repair Inguinal hernia repair | 49505 | $333 | $562 | $1,448 | 914 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $317 | $537 | $1,957 | 914 |
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 Pennsylvania
These hospitals in Pennsylvania are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
WASHINGTON, PA
ROYERSFORD, PA
YORK, PA
WYOMISSING, PA
MUNCY, PA
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 Pennsylvania
Pennsylvania's healthcare costs run approximately 9% above the national average, driven by the concentration of major academic medical centers and the state's aging population requiring complex surgical care. The Commonwealth's geographic diversity creates significant cost variations between the dense provider networks of Philadelphia and Pittsburgh versus the more limited specialist access in rural counties.
Urban vs. Rural Provider Availability
Pennsylvania's breast surgeons are heavily concentrated in the Philadelphia and Pittsburgh metropolitan areas, with limited specialist availability in the state's extensive rural regions. Patients in counties like Potter, Forest, and Cameron often travel over 100 miles to reach specialized breast cancer centers. This geographic disparity means rural patients may face higher travel costs but potentially lower procedure fees at regional hospitals.
Facility Type and Overhead Costs
Pennsylvania's major health systems like Penn Medicine, UPMC, and Jefferson Health operate hospital-based surgical practices with higher overhead costs than independent surgical groups. Academic medical centers in Philadelphia and Pittsburgh typically charge facility fees that can add $500-1,500 to consultation costs. Community hospitals throughout central and western Pennsylvania often offer more competitive pricing while maintaining quality care standards.
Insurance Market Competition in Pennsylvania
The Pennsylvania insurance market is moderately concentrated, with Highmark dominating western regions and Independence Blue Cross controlling southeastern markets, while United Healthcare competes statewide. This regional concentration can limit negotiating power and contribute to higher rates in areas with less insurer competition. Rural counties often have fewer plan options, which can affect provider network adequacy and pricing transparency.
Physician Supply and Demand in Pennsylvania
With 976 active Mastectomy providers serving Pennsylvania's 13 million residents, the state maintains adequate specialist coverage in urban areas but faces shortages in rural regions. The concentration of providers in academic centers creates competitive pricing in metropolitan areas while potentially limiting access and increasing costs in underserved counties. Wait times for consultations are generally shorter in cities but may extend several weeks in rural areas.
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 Pennsylvania
What is the average cost of a Mastectomy visit in Pennsylvania without insurance?
Does Pennsylvania Medicaid cover Mastectomy visits?
How do I find an affordable Mastectomy near me in Pennsylvania?
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 Pennsylvania?
How does telemedicine affect the cost of seeing a Mastectomy in Pennsylvania?
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 |