CMS Price Transparency Data

Breast lump removal

Facility: Mc Donough District Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$611
about 0.2× the $4,000 Medicare rate · typically $352–$2,081
modeled estimate · not a bill or quote
What this hospital charges insurers
$623
About the fair price
about $12 over the fair price · 0.2× Medicare
Medicare pays $4,000 Fair price $611 This hospital $623

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

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

Cheapest $444 Priciest $656

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

A fair price for a Breast lump removal is about $611 (about 0.2× the $4,000 Medicare rate). Mc Donough District Hospital charges insurers about $623 — about the fair price. Located in Macomb, IL.

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 $270 - $4,275 7%
Blue Cross Blue Shieldmajor $1,670 42%
Aetnamajor $295 - $4,275 7%
Humanamajor $295 - $4,275 7%
Meridian $295 - $4,275 7%
Molina $295 - $757 7%
+ 3 smaller / regional plans $177 - $4,275
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals