CMS Price Transparency Data

Breast lump removal

Facility: Mt Sinai Hospital Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$4,064

about 1.0× the $4,000 Medicare rate · typically $2,826–$4,456

modeled estimate · not a bill or quote

Medicare pays $4,000 Fair price $4,064 Cash price $1,147 Hospital's list price $1,639

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.

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana UnitedHealthcareKaiser 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	$733 - $4,196	18%
Aetnamajor	$2,008 - $3,704	50%
Cignamajor	$2,026 - $3,944	51%
Humanamajor	$4,196 - $5,146	105%
Ambetter (Centene)	$1,721 - $4,615	43%
Health Net	$2,008 - $4,070	50%
HealthLink	$1,065	27%
Meridian	$4,196	105%
Molina	$2,108 - $4,406	53%
Oscar Health	$1,803	45%
+ 10 smaller / regional plans	$656 - $4,615

Government programs also on file: Military & VA.

Excludes 6 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 1,147), 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 Mt Sinai Hospital 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 Mt Sinai Hospital Medical Center

Compare: Breast lump removal at other IL hospitals

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