CMS Price Transparency Data

Breast lump removal

Facility: Boone County Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$532

about 0.1× the $4,000 Medicare rate · typically $482–$1,549

modeled estimate · not a bill or quote

What this hospital charges insurers

$484

About the fair price

about $48 under the fair price · 0.1× Medicare

Medicare pays $4,000 Fair price $532 This hospital $484 Cash price $512 Hospital's list price $640

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

One of the lower prices — 7 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 $532 (about 0.1× the $4,000 Medicare rate). Boone County Hospital charges insurers about $484, or about $512 in cash — about the fair price. Located in Boone, IA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$153 - $583	4%
Blue Cross Blue Shieldmajor	$799 - $2,537	20%
Aetnamajor	$156 - $728	4%
Humanamajor	$131 - $840	3%
Amerigroup	$133 - $386	3%
HealthPartners	$788	20%
Meridian	$168 - $800	4%
+ 7 smaller / regional plans	$131 - $886

Government programs also on file: Medicaid, Military & VA.

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 512), 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 Boone County 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 Boone County Hospital

Compare: Breast lump removal at other IA hospitals

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