CMS Price Transparency Data

Breast lump removal

Facility: Van Diest Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$964

about 0.2× the $4,000 Medicare rate · typically $481–$2,622

modeled estimate · not a bill or quote

What this hospital charges insurers

$753

Below the fair price — a good deal

about $211 under the fair price · 0.2× Medicare

Medicare pays $4,000 Fair price $964 This hospital $753 Cash price $1,299 Hospital's list price $1,624

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

On the higher side — 7 of 8 other IA hospitals charge less.

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 $964 (about 0.2× the $4,000 Medicare rate). Van Diest Medical Center charges insurers about $753, or about $1,299 in cash — below the fair price — a good deal. Located in Webster City, IA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Aetna✓ Humana Blue 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
UnitedHealthcaremajor	$753 - $1,462	19%
Aetnamajor	$926 - $1,462	23%
Humanamajor	$731	18%
Amerigroup	$738 - $937	18%
Molina	$941	24%
+ 4 smaller / regional plans	$731 - $1,232

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 1,299), 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 Van Diest 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 Van Diest Medical Center

Compare: Breast lump removal at other IA hospitals

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