CMS Price Transparency Data

Breast lump removal

Facility: Adventist Health Reedley

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,697

about 0.4× the $4,000 Medicare rate · typically $517–$3,475

modeled estimate · not a bill or quote

What this hospital charges insurers

$546

Below the fair price — a good deal

about $1,151 under the fair price · 0.1× Medicare

Medicare pays $4,000 Fair price $1,697 This hospital $546 Cash price $344 Hospital's list price $1,812

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

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

Cheapest $445 Priciest $546

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

A fair price for a Breast lump removal is about $1,697 (about 0.4× the $4,000 Medicare rate). Adventist Health Reedley charges insurers about $546, or about $344 in cash — below the fair price — a good deal. Located in Reedley, CA.

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✓ Kaiser Permanente Humana

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	$405 - $23,781	10%
Blue Cross Blue Shieldmajor	$375 - $10,863	9%
Aetnamajor	$335 - $13,210	8%
Cignamajor	$467 - $1,402	12%
Kaiser Permanentemajor	$375 - $5,036	9%
Bright Health	$589 - $7,906	15%
Health Net	$375 - $5,036	9%
+ 19 smaller / regional plans	$211 - $10,215

Government programs also on file: Medicaid, 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 (about 344), 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 Adventist Health Reedley 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 Adventist Health Reedley

Compare: Breast lump removal at other CA hospitals

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