Last updated: March 2026
How Much Does Lumpectomy (Breast-Conserving Surgery) Cost?
Cost Breakdown by Type
| Type / Procedure | Without Insurance | With Insurance |
|---|---|---|
| Standard Lumpectomy | $5,000 – $12,000 | $1,000 – $3,000 |
| Lumpectomy with Sentinel Node Biopsy | $8,000 – $15,000 | $1,500 – $3,500 |
| Wire-Localized Lumpectomy | $6,000 – $14,000 | $1,200 – $3,200 |
CPT/ADA Code: 19301
What Affects the Cost
- Brand-name vs. generic availability
- Insurance formulary tier placement
- Pharmacy choice (retail vs. mail-order vs. Costco)
- Manufacturer savings cards and coupons
- Dosage and quantity prescribed
- Geographic location
Insurance Coverage
Typical coverage: Medically necessary — covered for breast cancer treatment
Most insurance plans use a tiered formulary: Tier 1 (generic) $0-$15 copay, Tier 2 (preferred brand) $25-$75, Tier 3 (non-preferred brand) $50-$150, Tier 4 (specialty) $100-$500+. Prior authorization may be required for certain medications. Step therapy may require trying cheaper alternatives first.
How to Save Money
- Always ask for generic when available — saves 50-90%
- Use GoodRx, RxSaver, or similar discount cards
- Costco pharmacy is open to non-members and often has lowest prices
- Mark Cuban's Cost Plus Drugs offers transparent low pricing
- Manufacturer patient assistance programs provide free medication to qualifying patients
- HSA/FSA funds can cover medication costs tax-free
Related Procedures & Costs
Frequently Asked Questions
A lumpectomy costs $5,000 to $15,000 without insurance. Radiation therapy typically follows and adds to the total treatment cost.
Lumpectomy removes only the tumor and surrounding tissue, while mastectomy removes the entire breast. Lumpectomy plus radiation has similar survival rates to mastectomy for many cancers.
Most patients go home the same day. Recovery takes 1-2 weeks, with most returning to work within a week.