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National price data · 2,008 hospitals

Breast lump removal cost

What a breast lump removal costs across the U.S. — and the fair price to aim for.

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%) 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Daviess Community Hospital prices shoppable and inpatient services (1.6× to 1.1× Medicare, divergence 0.69×) in alignment with regional hospital peers (1.04× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#45 of 107 in IN · 41st State Percentile#1,456 of 3,385 in U.S. · 42nd National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.56× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 54% of shoppable procedures (99/100 Cash Honesty)
  • CMS clinical safety score (65/100 safety score) with 64% patient recommendation
  • Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Watchout

Where You Can Get Burned (Markup Traps)

  • Outpatient surgery & OR suites carry a 2.0× markup over Medicare rates
  • Commercial insurance median sits at 1.07× Fair BaseRate (1.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 1.27×) jump +19% above the median procedure ratio (Q50 1.07×)
  • Consolidated metro market (HHI 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
1.6× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.69× Divergence
1.1× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+19% Upper Tail
Q25 0.56× · Q50 1.07× · Q75 1.27×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.
Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×
Front-Door Shoppable CareFront-Door Shoppable
1.6× MedicareGood
Outpatient Surgery & ORBack-Door Captive
2.0× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
4.8× MedicareWatchout
Back-Door Captive ER VisitsBack-Door Captive
0.7× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
1.9× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.0× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
54% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 65/100Fair
National Geographic Price Intelligence · 50-State + DC/PR Cartogram

National State Price Index Heatmap · Breast lump removal

State commercial price index vs. U.S. median (1.00×) and average Medicare multiple across all 53 priced states & territories

<0.93× Below Fair Price 0.93–1.05× Near Average 1.05–1.18× Elevated >1.18× High-Cost State
IA0.35×1.7× MedME0.35×1.3× MedMT0.35×1.2× MedOR0.35×2.2× MedPR0.35×1.1× MedUT0.35×1.3× MedVT0.35×1.0× MedWY0.35×1.2× MedID0.36×2.4× MedMI0.39×2.6× MedCT0.42×2.8× MedKS0.62×4.2× MedNE0.78×5.3× MedIN0.80×5.4× MedMO0.80×5.4× MedAK0.85×5.8× MedNH0.89×6.0× MedAR0.90×6.1× MedLA0.90×6.1× MedAL0.91×6.1× MedNV0.92×6.2× MedTN0.93×6.3× MedKY0.95×6.5× MedMS0.96×6.5× MedNY0.96×6.5× MedPA0.97×6.6× MedOH0.98×6.6× MedMN0.99×6.7× MedNC0.99×6.7× MedOK1.00×6.8× MedTX1.00×6.8× MedND1.01×6.8× MedWV1.01×6.8× MedSC1.02×6.9× MedSD1.02×6.9× MedCO1.06×7.2× MedAZ1.08×7.3× MedIL1.08×7.3× MedHI1.09×7.4× MedWI1.10×7.5× MedFL1.13×7.6× MedGA1.13×7.6× MedNJ1.15×7.8× MedMD1.20×1.2× MedDC1.21×8.2× MedMA1.21×8.2× MedNM1.22×8.3× MedDE1.26×8.5× MedCA1.29×8.7× MedVA1.48×10.0× MedWA1.66×11.2× MedRI1.73×11.7× Med
5 Lowest-Price States (Confounder-Isolated Value Leaders)
IA0.35×(1.7×)ME0.35×(1.3×)MT0.35×(1.2×)OR0.35×(2.2×)PR0.35×(1.1×)
5 Highest-Markup States (Strict Bill Audit Recommended)
RI1.73×(11.7×)WA1.66×(11.2×)VA1.48×(10.0×)CA1.29×(8.7×)DE1.26×(8.5×)
The BaseRate high confidence
$3,733
the fair national price for a breast lump removal
typically $595–$7,059 across 2,008 hospitals · how we calculate it
modeled estimate · not a bill or quote
2,008
hospitals priced
52
states
11.9×
price spread — where shopping matters
6.8×
vs. Medicare

Across 2,008 hospitals in 52 states, a breast lump removal has a fair BaseRate of $3,733 and typically costs $595–$7,059. The cheapest state is VT; the priciest is RI.

Cheapest hospitals for a breast lump removal

Breast lump removal cost by state

AK $3,296 6 hospitals AL $3,515 34 hospitals AR $3,496 24 hospitals AZ $4,178 35 hospitals CA $4,983 156 hospitals CO $4,110 35 hospitals CT $1,616 11 hospitals DC $4,672 4 hospitals DE $4,872 6 hospitals FL $4,375 118 hospitals GA $4,368 53 hospitals HI $4,228 10 hospitals IA $977 50 hospitals ID $1,390 16 hospitals IL $4,175 65 hospitals IN $3,081 51 hospitals KS $2,421 34 hospitals KY $3,697 29 hospitals LA $3,481 48 hospitals MA $4,692 31 hospitals ME $754 22 hospitals MI $1,492 63 hospitals MN $3,822 54 hospitals MO $3,117 35 hospitals MS $3,727 34 hospitals MT $701 10 hospitals NC $3,852 39 hospitals ND $3,906 9 hospitals NE $3,014 34 hospitals NH $3,436 10 hospitals NJ $4,443 46 hospitals NM $4,739 11 hospitals NV $3,559 16 hospitals NY $3,727 64 hospitals OH $3,782 96 hospitals OK $3,877 32 hospitals OR $1,250 19 hospitals PA $3,775 68 hospitals PR $615 2 hospitals RI $6,702 5 hospitals SC $3,949 40 hospitals SD $3,944 9 hospitals TN $3,600 58 hospitals TX $3,890 208 hospitals UT $753 33 hospitals VA $5,716 43 hospitals VT $552 9 hospitals WA $6,427 42 hospitals WI $4,277 64 hospitals WV $3,924 13 hospitals WY $684 3 hospitals
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.3%

Audit a Bill or Quote at U.S. Hospital Benchmark (Zero PHI Required)

Fair BaseRate™ $3,733
Medicare Rate $2,165
Self-Pay Cash Request Quote
Insurer Median $3,875
Pre-filled with U.S. Hospital Benchmark’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $3,376 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $3,376

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $3,376).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask U.S. Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$5,567 Above Fair BaseRate

Negotiate Toward $3,733 Fair BaseRate ($2,165 Medicare)

Your bill ($9,300) is $5,567 above the denoised Fair BaseRate ($3,733) and 4.3× the $2,165 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.