CMS Price Transparency Data

Breast lump removal

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$748

about 0.2× the $4,000 Medicare rate · typically $534–$3,147

modeled estimate · not a bill or quote

What this hospital charges insurers

$619

Below the fair price — a good deal

about $129 under the fair price · 0.2× Medicare

Medicare pays $4,000 Fair price $748 This hospital $619 Cash price $1,386 Hospital's list price $2,132

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

A typical price — 3 charge more and 4 charge less, among the 9 FL hospitals compared.

Cheapest $506 Priciest $678

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

A fair price for a Breast lump removal is about $748 (about 0.2× the $4,000 Medicare rate). Cleveland Clinic Indian River Hospital charges insurers about $619, or about $1,386 in cash — below the fair price — a good deal. Located in Vero Beach, FL.

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	$383 - $6,534	10%
Blue Cross Blue Shieldmajor	$383 - $3,844	10%
Aetnamajor	$538 - $7,079	13%
Cignamajor	$532 - $682	13%
Humanamajor	$3,844	96%
AmeriHealth	$403	10%
AvMed	$449 - $8,802	11%
Devoted Health	$4,228	106%
Molina	$403	10%
WellCare	$403 - $3,844	10%
WellMed	$471 - $3,844	12%
+ 11 smaller / regional plans	$403 - $4,036

Government programs also on file: Medicaid.

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 1,386), 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 Cleveland Clinic Indian River 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 Cleveland Clinic Indian River Hospital

Compare: Breast lump removal at other FL hospitals

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