CMS Price Transparency Data

Breast lump removal

Facility: Valleywise Health Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,385

about 0.3× the $4,000 Medicare rate · typically $597–$3,013

modeled estimate · not a bill or quote

What this hospital charges insurers

$555

Below the fair price — a good deal

about $830 under the fair price · 0.1× Medicare

Medicare pays $4,000 Fair price $1,385 This hospital $555 Hospital's list price $3,995

How we calculate the fair BaseRate →

How this hospital compares to other AZ hospitals

One of the lower prices — 7 of 8 other AZ hospitals charge more for the same procedure.

Cheapest $497 Priciest $2,289

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

A fair price for a Breast lump removal is about $1,385 (about 0.3× the $4,000 Medicare rate). Valleywise Health Medical Center charges insurers about $555 — below the fair price — a good deal. Located in Phoenix, AZ.

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	$433 - $5,409	11%
Blue Cross Blue Shieldmajor	$398 - $4,178	10%
Aetnamajor	$396 - $4,745	10%
Cignamajor	$324 - $5,840	8%
Humanamajor	$472 - $4,178	12%
Banner Health	$374 - $4,178	9%
Devoted Health	$398 - $4,178	10%
Health Net	$336 - $7,990	8%
Molina	$402 - $4,596	10%
Oscar Health	$457 - $2,409	11%
+ 12 smaller / regional plans	$242 - $8,106

Government programs also on file: Military & VA.

Excludes 1 rental-network / third-party entry (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, 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 Valleywise Health 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 Valleywise Health Medical Center

Compare: Breast lump removal at other AZ hospitals

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