CMS Price Transparency Data

Breast lump removal

Facility: Greene County Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,003

about 0.3× the $4,000 Medicare rate · typically $481–$2,511

modeled estimate · not a bill or quote

What this hospital charges insurers

$499

Below the fair price — a good deal

about $504 under the fair price · 0.1× Medicare

Medicare pays $4,000 Fair price $1,003 This hospital $499 Cash price $831 Hospital's list price $1,484

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

One of the lower prices — 6 of 8 other IA hospitals charge more for the same procedure.

Cheapest $465 Priciest $757

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

A fair price for a Breast lump removal is about $1,003 (about 0.3× the $4,000 Medicare rate). Greene County Medical Center charges insurers about $499, or about $831 in cash — below the fair price — a good deal. Located in Jefferson, IA.

What each insurance company pays

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

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

✓ Aetna✓ Humana UnitedHealthcareBlue Cross Blue ShieldCignaKaiser 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
Aetnamajor	$619	15%
Humanamajor	$379	9%
Ambetter (Centene)	$341	9%
+ 1 smaller / regional plan	$1,410

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 831), 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 Greene County 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 Greene County Medical Center

Compare: Breast lump removal at other IA hospitals

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