CMS Price Transparency Data

Breast lump removal

Facility: Madison Memorial Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$3,014
about 0.8× the $4,000 Medicare rate · typically $2,131–$3,847
modeled estimate · not a bill or quote
What this hospital charges insurers
$3,849
Above the fair price
about $835 over the fair price · 1.0× Medicare
Medicare pays $4,000 Fair price $3,014 This hospital $3,849 Cash price $5,432 Hospital's list price $7,242

How we calculate the fair BaseRate →

How this hospital compares to other ID hospitals

Highest price of the 9 ID hospitals we have prices for — worth calling around.

Cheapest $517 Priciest $3,849

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

A fair price for a Breast lump removal is about $3,014 (about 0.8× the $4,000 Medicare rate). Madison Memorial Hospital charges insurers about $3,849, or about $5,432 in cash — above the fair price. Located in Rexburg, ID.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $3,014. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser 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
Blue Cross Blue Shieldmajor $3,849 96%
Aetnamajor $3,829 - $3,849 96%
Moda Health $7,699 192%
Molina $3,849 96%
SelectHealth $3,888 97%
+ 3 smaller / regional plans $3,849 - $6,544
Government programs also on file: Military & VA.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 450 East Main Street, Rexburg, ID 83440
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals