CMS Price Transparency Data

Breast lump removal

Facility: Mercy San Juan Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$5,380
about 1.3× the $4,000 Medicare rate · typically $2,898–$8,295
modeled estimate · not a bill or quote
What this hospital charges insurers
$5,063
About the fair price
about $317 under the fair price · 1.3× Medicare
Medicare pays $4,000 Fair price $5,380 This hospital $5,063

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 $5,063

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 $5,380 (about 1.3× the $4,000 Medicare rate). Mercy San Juan Medical Center charges insurers about $5,063 — about the fair price. Located in Carmichael, 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✓ Humana✓ Kaiser Permanente Cigna

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 $302 - $5,032 8%
Blue Cross Blue Shieldmajor $574 - $17,696 14%
Aetnamajor $5,032 - $8,286 126%
Humanamajor $5,032 126%
Kaiser Permanentemajor $5,032 126%
Health Net $692 - $12,770 17%
Molina $396 - $5,032 10%
+ 6 smaller / regional plans $332 - $7,548

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Facility Profile & Credentials

  • Address: 6501 Coyle Ave, Carmichael, CA 95608
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals