CMS Price Transparency Data

Breast lump removal

Facility: Oro Valley Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$4,231

about 1.1× the $4,000 Medicare rate · typically $1,236–$4,493

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,230

About the fair price

about $1 under the fair price · 1.1× Medicare

Medicare pays $4,000 Fair price $4,231 This hospital $4,230 Cash price $12,911 Hospital's list price $53,796

How we calculate the fair BaseRate →

How this hospital compares to other AZ hospitals

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

Cheapest $497 Priciest $4,230

Black dot = this hospital, among the 9 AZ 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 $4,231 (about 1.1× the $4,000 Medicare rate). Oro Valley Hospital charges insurers about $4,230, or about $12,911 in cash — about the fair price. Located in Oro Valley, 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	$3,522 - $4,402	88%
Blue Cross Blue Shieldmajor	$2,898 - $8,231	72%
Aetnamajor	$4,111 - $10,221	103%
Cignamajor	$4,111 - $4,336	103%
Humanamajor	$4,111	103%
Ambetter (Centene)	$5,891	147%
Banner Health	$4,317	108%
Clover Health	$4,220	105%
Devoted Health	$4,235	106%
Health Net	$8,774	219%
WellCare	$4,317	108%
+ 12 smaller / regional plans	$2,380 - $32,278

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

Excludes 6 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 12,911), 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 Oro Valley Hospital 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 Oro Valley Hospital

Compare: Breast lump removal at other AZ hospitals

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