CMS Price Transparency Data

Breast lump removal

Facility: Atrium Health Navicent the Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,193

about 0.5× the $4,000 Medicare rate · typically $753–$3,480

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,000

Below the fair price — a good deal

about $1,193 under the fair price · 0.3× Medicare

Medicare pays $4,000 Fair price $2,193 This hospital $1,000 Cash price $5,135 Hospital's list price $10,270

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

A typical price — 2 charge more and 5 charge less, among the 9 GA hospitals compared.

Cheapest $518 Priciest $1,125

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Breast lump removal is about $2,193 (about 0.5× the $4,000 Medicare rate). Atrium Health Navicent the Medical Center charges insurers about $1,000, or about $5,135 in cash — below the fair price — a good deal. Located in Macon, GA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 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	$398 - $5,936	10%
Blue Cross Blue Shieldmajor	$398 - $3,731	10%
Aetnamajor	$398 - $3,731	10%
Cignamajor	$747 - $3,157	19%
Humanamajor	$398 - $4,453	10%
Kaiser Permanentemajor	$1,000 - $2,707	25%
Ambetter (Centene)	$538 - $5,238	13%
Clover Health	$406 - $3,806	10%
+ 9 smaller / regional plans	$398 - $9,551

Excludes 2 rental-network / third-party entries (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 5,135), 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 Atrium Health Navicent the Medical Center 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 Atrium Health Navicent the Medical Center

Compare: Breast lump removal at other GA hospitals

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