CMS Price Transparency Data

Breast lump removal

Facility: Adventist Health Castle

Billing Code: 19120 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$4,340

about 1.1× the $4,000 Medicare rate · typically $533–$4,340

modeled estimate · not a bill or quote

Medicare pays $4,000 Fair price $4,340 Cash price $419 Hospital's list price $1,310

How we calculate the fair BaseRate →

What each insurance company pays

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

1 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare Blue Cross Blue ShieldAetnaCignaHumanaKaiser 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	$410	10%
Devoted Health	$423	11%
+ 8 smaller / regional plans	$263 - $1,572

Government programs also on file: Medicare, Medicaid.

Excludes 4 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 419), 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 Castle 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 Castle

Compare: Breast lump removal at other HI hospitals

Kohala Hospital · Kapaau $3,850
Kapiolani Medical Center for Women & Children · Honolulu $3,925
Kaiser Foundation Hospital · Honolulu $4,119
Kuakini Medical Center · Honolulu $4,237
The Queens Medical Center · Honolulu $4,536
Kona Community Hospital · Kealakekua $4,625
Pali Momi Medical Center · Aiea $4,743
Wilcox Memorial Hospital · Lihue $4,862

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