CMS Price Transparency Data

Breast lump removal

Facility: Saint Mary's Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $319
  • Cash Discount Price: $1,860
  • vs. Medicare Baseline: 0.08x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Saint Mary's Hospital is $319. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,860. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.08x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$1,860

Average discount available for prompt cash payment at this facility.

Insurance Median
$319

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4,000.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4,000.24 (100%)
Cash / Self-Pay: $1,860 (46%)
Insurance Median: $319 (8%)
Cash: $1,860 (46% of Medicare)
Ins. Median: $319 (8% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4,000.24 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $107 - $4,600 3%
Albany County Correctional Facility $107 - $160 3%
Ambetter / Centene $107 - $160 3%
Amish Mennonite $107 - $160 3%
Ascension St. Vincent Public Safety Medical $107 - $160 3%
Bcccp-Michigan $107 - $160 3%
Bccp $107 - $160 3%
Blue Cross Blue Shield $107 - $13,922 3%
Bmc Healthnet $107 - $160 3%
Breast Grant-Connecticut $107 - $160 3%
Broward County Dept of Health $107 - $160 3%
California Health and Wellness $107 - $160 3%
Can Community Health Inc $107 - $160 3%
Cardinal Innovations Lme $107 - $160 3%
Care Connections of Northern Iowa $107 - $160 3%
Care Oregon Ohp $107 - $160 3%
Cencal Health Plan $107 - $160 3%
Cenpatico $107 - $160 3%
Chhuny $107 - $160 3%
Childrens Comm Health Plan $107 - $160 3%
Childrens Medical Services Title 19 $107 - $160 3%
Cigna $107 - $4,738 3%
City of Philadelphia $107 - $160 3%
Cmh Allegan County $107 - $160 3%
Cmh Ausable Valley $107 - $160 3%
Cmh Barry County $107 - $160 3%
Cmh Bay-Arenac County $107 - $160 3%
Cmh Berrien County $107 - $160 3%
Cmh Cass County $107 - $160 3%
Cmh Central Mi County $107 - $160 3%
Cmh Clinton-Eaton-Ingham County $107 - $160 3%
Cmh Detroit Wayne Integrated Health Network $107 - $160 3%
Cmh Genesee County $107 - $160 3%
Cmh Ionia County $107 - $160 3%
Cmh Jackson County/Lifeways $107 - $160 3%
Cmh Kalamazoo $107 - $160 3%
Cmh Kent County $107 - $160 3%
Cmh Lenawee County $107 - $160 3%
Cmh Livingston County $107 - $160 3%
Cmh Macomb $107 - $160 3%
Cmh Misc $107 - $160 3%
Cmh Monroe County $107 - $160 3%
Cmh Montcalm County $107 - $160 3%
Cmh Muskegon County $107 - $160 3%
Cmh Newaygo County $107 - $160 3%
Cmh North Country $107 - $160 3%
Cmh Northern Lakes County $107 - $160 3%
Cmh Oakland County $107 - $160 3%
Cmh Ottawa County $107 - $160 3%
Cmh Van Buren County $107 - $160 3%
Cmh Washtenaw County $107 - $160 3%
Cmh Wayne County/Carelink $107 - $160 3%
Cmh Wayne Cty/Com Liv Svcs $107 - $160 3%
Cmh West Mi County $107 - $160 3%
Community Benefit Health $107 - $160 3%
Community Care Behavorial Health $107 - $160 3%
Community Care Partners $107 - $160 3%
Community Health Choice $107 - $160 3%
Connections Csp $107 - $160 3%
County Coroner $107 - $160 3%
County Funding Generic $107 - $160 3%
Covid19 Hrsa Uninsured Testing and Treatment Fund $107 - $160 3%
Dean Wi Badgercare $107 - $160 3%
Delaware County Department of Health $107 - $160 3%
Delaware First Health $107 - $160 3%
Dph Tb Program $107 - $160 3%
Dscc $107 - $160 3%
Eastpointe Lme $107 - $160 3%
Family Health Network $107 - $160 3%
Freedom First Healthcare $107 - $160 3%
Fresno County Ccs $107 - $160 3%
Ghc Scw Wi Badgercare $107 - $160 3%
Harbor Health $107 - $160 3%
Health Safety Net $107 - $160 3%
Healthy Blue Ne $107 - $160 3%
Hennepin Health $107 - $160 3%
Humana $107 - $319 3%
Id County Ada $107 - $160 3%
Id County Canyon $107 - $160 3%
Id County Cat Fund $107 - $160 3%
Id County Other $107 - $160 3%
Id County Payette $107 - $160 3%
Idaho Dept Health and Wellfare $107 - $160 3%
Idaho Womens Health Check $107 - $160 3%
Indiana Breast Cervical Cancer $107 - $160 3%
Inland Empire Health Plan $107 - $160 3%
Intercommunity Health Ohp $107 - $160 3%
Iowa Total Care $107 - $160 3%
Jai Medical System $107 - $160 3%
Kern Family Health Plan $107 - $160 3%
Keystone First $107 - $160 3%
Keystone First Chip $107 - $160 3%
La Care Health Plan $107 - $160 3%
Lakeland Care Inc $107 - $160 3%
Managed Health Services - Indiana $107 - $160 3%
Maryland Breast & Cervical Program $107 - $160 3%
Maryland Healthy Smiles - Scion Dental $107 - $160 3%
Maryland Physicians Care $107 - $160 3%
Massachusetts Behavioral Health Partnership $107 - $160 3%
Mdwise $107 - $160 3%
Medi-Cal $107 - $160 3%
Medi-Cal Healthnet $107 - $160 3%
Medicaid / KanCare $107 - $561 3%
Medstar Dc Healthy Family $107 - $160 3%
Medstar Md Health Choice $107 - $160 3%
Mo Home State Health Plan $107 - $160 3%
Molina Centennial Care $107 - $160 3%
Nascentia Health Options $107 - $160 3%
Nebraska Total Care $107 - $160 3%
New York Cancer Services Program $107 - $160 3%
Nextlevel Health $107 - $160 3%
Oregon Screenwise $107 - $160 3%
Pace of Southwest Michigan $107 - $319 3%
Paramount Advantage $107 - $160 3%
Parkland Community Health Plan $107 - $160 3%
Partners Behavioral Lme $107 - $160 3%
Peach State Healthplan $107 - $160 3%
Philadelphia County Funding $107 - $160 3%
Presbyterian Centennial Care $107 - $160 3%
Prestige Health Choice $107 - $160 3%
Priority Partners $107 - $160 3%
Robert F Sing Program $107 - $160 3%
Rx 340B Pass Along $107 - $160 3%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $107 - $160 3%
Rx Medi-Cal $107 - $160 3%
Rx Meridian Rx $107 - $160 3%
Ryan White Florida Mssrp $107 - $160 3%
Sandhills Center Lme $107 - $160 3%
Screening for Life $107 - $160 3%
St Joseph County Hlth Dpt $107 - $160 3%
Stephenson Cty Health $107 - $160 3%
Sunshine State Health Plan $107 - $160 3%
Superior Health $107 - $160 3%
Tenncare $107 - $160 3%
Texas Children's Health Plan $107 - $160 3%
Trillium Community Ohp $107 - $160 3%
Tufts Health Public Plans $107 - $160 3%
UnitedHealthcare $107 - $4,600 3%
Vaya Health Lme $107 - $160 3%
Washtenaw Health Plan $107 - $160 3%
Wellsense Health Plan $107 - $160 3%
Wi Womens Wellness $107 - $160 3%
Health New England $195 - $577 5%
Champva $212 - $319 5%
Tricare $212 - $319 5%
Triwest Health Alliance $212 - $319 5%
Veterans Eval Services $212 - $319 5%
Align Senior Care $213 - $319 5%
Ally Align Care Adv $213 - $319 5%
American Health Advantage of Idaho $213 - $319 5%
American Health Plan $213 - $319 5%
Aurora Special Needs $213 - $319 5%
Blue Care Network Advantage $213 - $319 5%
Blue Shield - De (Highmark) Medciare Advantage $213 - $319 5%
Care Dimensions $213 - $319 5%
Care Improvement Plus $213 - $319 5%
Care Resources Pace $213 - $319 5%
Careplus Health Plans $213 - $319 5%
Cca - Zing Health $213 - $319 5%
Central Valley Medical Services Corp Pace $213 - $319 5%
Champion Health Plan McR Advantage $213 - $319 5%
Clear Spring Health $213 - $319 5%
Clover Health $213 - $319 5%
Commonwealth Care Alliance $213 - $335 5%
Community Pace at Home $213 - $319 5%
Eddy Senior Care-Pace $213 - $319 5%
Eddy Seniorcare Pace $213 - $319 5%
Elementcare $213 - $319 5%
Evercare $213 - $319 5%
Everence $213 - $319 5%
Gateway Health Plan $213 - $319 5%
Genesys Pace of Genesee County $213 - $319 5%
Georgia Health Advantage $213 - $319 5%
Gold Advantage $213 - $319 5%
Gpa Croell Redi Mix $213 - $319 5%
Health America Advantra $213 - $319 5%
Highmark Health Options Dual Plan $213 - $319 5%
Hope Select Pace $213 - $319 5%
Horizon Nj Total Care $213 - $319 5%
Hudson Headwaters Pace $213 - $319 5%
Huron Valley Pace $213 - $319 5%
Innovative Integrated Health Community Plans $213 - $319 5%
Iowa Health Advantage $213 - $319 5%
Johns Hopkins Advantage Md $213 - $319 5%
Lasso Healthcare Msa $213 - $319 5%
Life St Marys Pace $213 - $319 5%
Lifecircles Pace $213 - $319 5%
Longevity Health Plan $213 - $319 5%
Longevity IPA of Michigan LLC Health Plan Isnp $213 - $319 5%
Martins Point Generations Advantage $213 - $319 5%
Mass General Brigham McR Adv $213 - $319 5%
Medicare (plans) $213 - $4,788 5%
Medipak Advantage $213 - $319 5%
Mercy Life $213 - $319 5%
Mercyone Cedar Valley $213 - $319 5%
Meridian Complete $213 - $319 5%
Michigan Complete Health $213 - $319 5%
Nascentia Health Plus $213 - $319 5%
New Centry Health Careplus $213 - $319 5%
Osu Prime Care Advantage $213 - $319 5%
Pace Cny $213 - $319 5%
Pace Iowa Immanuel Pathways $213 - $319 5%
Pace Southeast $213 - $319 5%
Pace-Trinity Health $213 - $319 5%
Peak Pace Solutions $213 - $319 5%
Perennial Advantage $213 - $319 5%
Preferred Care Partners $213 - $319 5%
Presbyterian Senior Plan $213 - $319 5%
Provider Partners Health Plan of Illinois $213 - $319 5%
Provider Partners Health Plan of Indiana $213 - $319 5%
Pruitthealth Premier $213 - $319 5%
Reliance Community Care Partners Care Resources Pace $213 - $319 5%
Rx Allwin $213 - $319 5%
Rx Grane Grnmedd $213 - $319 5%
Rx Retiree Rx Care $213 - $319 5%
Scan Health Plan McR IPA Meritage Oon $213 - $319 5%
Secure Horizons Ma Pffs $213 - $319 5%
Serenity Pace $213 - $319 5%
Siouxland Pace $213 - $319 5%
Solis Health Plans $213 - $319 5%
Sunnyview-Pace Finance Dept $213 - $319 5%
Texan Plus $213 - $319 5%
The Health Plan $213 - $319 5%
Thome Pace $213 - $319 5%
Todays Options $213 - $319 5%
Tribute Health Plans $213 - $319 5%
Um Health Advantage $213 - $319 5%
Union Health Service $213 - $319 5%
Welbe Health $213 - $319 5%
Wellmed $213 - $319 5%
Veterans Administration $217 - $326 5%
Cca Senior Care Options $219 - $4,692 5%
Us Family Health Plan $221 - $573 6%
Fallon Health $266 - $670 7%
Mass General Brigham Health Plan $316 - $694 8%
Connecticare $320 - $621 8%
Unicare $374 - $13,922 9%
Wellpoint $374 - $13,922 9%
Claimdoc $380 - $9,857 9%
Innovative Health Plan II $380 - $9,857 9%
Bcn Domestic $408 - $13,922 10%
Blue Benefit Administrators of Massachusetts $408 - $13,922 10%
Blue Care Network $408 - $13,922 10%
Blue Distinction Transplant $408 - $13,922 10%
Blue Shield - Ca $408 - $13,922 10%
Blue Shield - Id (Regence) $408 - $13,922 10%
Blue Shield - Ny Highmark Northeastern $408 - $13,922 10%
Blue Shield - Ny Highmark Western $408 - $13,922 10%
Blue Shield - PA (Highmark) $408 - $13,922 10%
Blue Shield - Wa (Regence) $408 - $13,922 10%
Health Choices $408 - $13,922 10%
Kaiser Domestic $408 - $13,922 10%
Pre-Employment $408 - $13,922 10%
Wc Domestic $408 - $13,922 10%
Multiplan $428 - $642 11%
Tufts Health Plan $455 - $682 11%
Healthscope $457 - $685 11%
Harvard Pilgrim Healthcare $475 - $713 12%
Centivo $500 - $9,388 12%
Coventry $508 - $762 13%
First Health $508 - $762 13%
Guardian $508 - $762 13%
Meritain $508 - $762 13%
Prime Health Services $522 - $782 13%
Andrie Inc $532 - $798 13%
East Greenbush Central School District $532 - $798 13%
Genex Wc $532 - $798 13%
Healthsmart Workers Comp $532 - $798 13%
Jag Source $532 - $798 13%
New York State Insurance Fund $532 - $798 13%
Njm Insurance Group $532 - $798 13%
Rx Heatlhcomp $532 - $798 13%
Rx Restat $532 - $798 13%
Rx Saif Opdp Wc $532 - $798 13%
Rx Worker's Comp $532 - $798 13%
Wc Accident Fund $532 - $798 13%
Wc Ace $532 - $798 13%
Wc Acs Federal Employees $532 - $798 13%
Wc Acuity $532 - $798 13%
Wc Advantage $532 - $798 13%
Wc Aegis $532 - $798 13%
Wc Aig $532 - $798 13%
Wc Aims $532 - $798 13%
Wc Alaska National Ins $532 - $798 13%
Wc Align Network $532 - $798 13%
Wc Allied $532 - $798 13%
Wc Am Trust N America $532 - $798 13%
Wc American Claims Mgmt $532 - $798 13%
Wc Amerisure $532 - $798 13%
Wc Amtrust $532 - $798 13%
Wc Asu Risk Mgt $532 - $798 13%
Wc Benetech $532 - $798 13%
Wc Berkley Admin $532 - $798 13%
Wc Broadspire $532 - $798 13%
Wc Broward County $532 - $798 13%
Wc Bunch & Associates $532 - $798 13%
Wc California State Comp Ins $532 - $798 13%
Wc California State Ins Fund $532 - $798 13%
Wc Capitol Area Health Consortium $532 - $798 13%
Wc Ccmsi $532 - $798 13%
Wc Chartis $532 - $798 13%
Wc Chubb $532 - $798 13%
Wc Cirma $532 - $798 13%
Wc City of Albany $532 - $798 13%
Wc City of Sioux City $532 - $798 13%
Wc Claims Mgmt Inc $532 - $798 13%
Wc Cna $532 - $798 13%
Wc Comp One Admin C/O Manageability $532 - $798 13%
Wc Compone Admin $532 - $798 13%
Wc Ct Healthcare Trust $532 - $798 13%
Wc Donegal Insurance Group $532 - $798 13%
Wc Emc Insurance Company $532 - $798 13%
Wc Employee Mutual $532 - $798 13%
Wc Enablecomp $532 - $798 13%
Wc Encore Health Network $532 - $798 13%
Wc Erie $532 - $798 13%
Wc Esis $532 - $798 13%
Wc Evolutions $532 - $798 13%
Wc Fcci $532 - $798 13%
Wc Fed Ex $532 - $798 13%
Wc Federal Black Lung $532 - $798 13%
Wc Federated $532 - $798 13%
Wc Finley Occupational Health $532 - $798 13%
Wc First Agency/Occunet $532 - $798 13%
Wc Ford Motor $532 - $798 13%
Wc Fresno Unified Emp $532 - $798 13%
Wc Gallagher Bassett $532 - $798 13%
Wc General Motors $532 - $798 13%
Wc Generic $532 - $798 13%
Wc Genex Care for Ohio $532 - $798 13%
Wc Great West Casualty $532 - $798 13%
Wc Guarantee Insurance $532 - $798 13%
Wc Guard Insurance Company $532 - $798 13%
Wc Hab $532 - $798 13%
Wc Hartford $532 - $798 13%
Wc Hastings $532 - $798 13%
Wc Health Management $532 - $798 13%
Wc Heritage Summit $532 - $798 13%
Wc Hireright $532 - $798 13%
Wc Horizon $532 - $798 13%
Wc Icw Group $532 - $798 13%
Wc Idaho State Ins Fund $532 - $798 13%
Wc Intercare Insurance $532 - $798 13%
Wc Intermountain $532 - $798 13%
Wc Johns Eastern $532 - $798 13%
Wc Kemberton $532 - $798 13%
Wc Key Ins & Benefit Solutions $532 - $798 13%
Wc Liberty Mutual $532 - $798 13%
Wc Mac Risk Management $532 - $798 13%
Wc Massachusetts $532 - $798 13%
Wc Mdia $532 - $798 13%
Wc Meadowbrook Claim $532 - $798 13%
Wc Medical Administrators $532 - $798 13%
Wc Meijers $532 - $798 13%
Wc Memic $532 - $798 13%
Wc Mercy Workcare $532 - $798 13%
Wc Michigan $532 - $798 13%
Wc Michigan Millers Mutual $532 - $798 13%
Wc Mitchell Frankenmuth $532 - $798 13%
Wc Mra $532 - $798 13%
Wc Nationwide $532 - $798 13%
Wc Nca Comp $532 - $798 13%
Wc New York $532 - $798 13%
Wc New York Special Funds $532 - $798 13%
Wc North American Rishces $532 - $798 13%
Wc Northeast Health $532 - $798 13%
Wc Notre Dame $532 - $798 13%
Wc Novanet $532 - $798 13%
Wc O'Hara Corp $532 - $798 13%
Wc Occ Health Allen $532 - $798 13%
Wc Ohio Bureau $532 - $798 13%
Wc One Call Medical $532 - $798 13%
Wc Paradigm $532 - $798 13%
Wc Peerless $532 - $798 13%
Wc Pma $532 - $798 13%
Wc Praxis Health Network $532 - $798 13%
Wc Price Chopper $532 - $798 13%
Wc Procura Management $532 - $798 13%
Wc Qualcare $532 - $798 13%
Wc Quiktrip $532 - $798 13%
Wc Reny Company $532 - $798 13%
Wc Rev Claims $532 - $798 13%
Wc Risico $532 - $798 13%
Wc Rural Mutual $532 - $798 13%
Wc Saif Oregon $532 - $798 13%
Wc Secura $532 - $798 13%
Wc Sedgwick $532 - $798 13%
Wc Sentry $532 - $798 13%
Wc Sheakley Unicomp $532 - $798 13%
Wc Smile Lodge $532 - $798 13%
Wc Society $532 - $798 13%
Wc Srs $532 - $798 13%
Wc Taconic (Mro) $532 - $798 13%
Wc Taconic Farms $532 - $798 13%
Wc Travelers $532 - $798 13%
Wc Triad Group $532 - $798 13%
Wc Tristar $532 - $798 13%
Wc Troy Ny $532 - $798 13%
Wc Tyson $532 - $798 13%
Wc Unified Health Services $532 - $798 13%
Wc United Heartland $532 - $798 13%
Wc Us Dept of Labor $532 - $798 13%
Wc Velocity $532 - $798 13%
Wc Walmart $532 - $798 13%
Wc West Bend $532 - $798 13%
Wc West Bend Mutual/Argent $532 - $798 13%
Wc Winnebago Industries $532 - $798 13%
Wc Yankee Trails $532 - $798 13%
Wc York Risk $532 - $798 13%
Wc Zenith $532 - $798 13%
Wc Zurich $532 - $798 13%
Health Smart $790 - $1,581 20%
Wc Corvel $790 - $1,581 20%
Delta Dental Ga $930 - $1,860 23%
Delta Dental Mi $930 - $1,860 23%
Delta Dental Mo $930 - $1,860 23%
Delta Dental Nj $930 - $1,860 23%
Delta Dental Ny $930 - $1,860 23%
Delta Dental Oh $930 - $1,860 23%
Delta Dental Or $930 - $1,860 23%
Delta Dental PA $930 - $1,860 23%
Delta Dental VA $930 - $1,860 23%
Delta Dental Wa $930 - $1,860 23%
Liberty Dental $930 - $1,860 23%
Connecticut Dept of Correction $4,335 108%
Diversified Administrators $9,857 246%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals