CMS Price Transparency Data

Breast lump removal

Facility: Grandview Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,641

about 0.9× the $4,000 Medicare rate · typically $3,163–$3,963

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,581

About the fair price

about $60 under the fair price · 0.9× Medicare

Medicare pays $4,000 Fair price $3,641 This hospital $3,581 Cash price $13,636 Hospital's list price $90,905

How we calculate the fair BaseRate →

How this hospital compares to other AL hospitals

Highest price of the 9 AL hospitals we have prices for — worth calling around.

Cheapest $555 Priciest $3,581

Black dot = this hospital, among the 9 AL hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Breast lump removal is about $3,641 (about 0.9× the $4,000 Medicare rate). Grandview Medical Center charges insurers about $3,581, or about $13,636 in cash — about the fair price. Located in Birmingham, AL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$3,524 - $40,907	88%
Blue Cross Blue Shieldmajor	$2,412	60%
Aetnamajor	$2,600 - $3,629	65%
Cignamajor	$3,595 - $6,254	90%
Humanamajor	$3,524	88%
Ambetter (Centene)	$5,372	134%
Cigna HealthSpring	$6,267	157%
Clover Health	$3,617	90%
Devoted Health	$3,595	90%
SelectHealth	$3,559	89%
WellCare	$3,653	91%
+ 20 smaller / regional plans	$366 - $81,814

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 13,636), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 19120.

Insurance Before you use insurance

Call your insurance company to confirm Grandview Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 19120.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Grandview Medical Center

Compare: Breast lump removal at other AL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.