CMS Price Transparency Data

Breast lump removal

Facility: Anderson Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,702

about 0.9× the $4,000 Medicare rate · typically $2,156–$5,314

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,129

About the fair price

about $427 over the fair price · 1.0× Medicare

Medicare pays $4,000 Fair price $3,702 This hospital $4,129 Cash price $12,211 Hospital's list price $20,351

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

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

Cheapest $444 Priciest $4,129

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 $3,702 (about 0.9× the $4,000 Medicare rate). Anderson Hospital charges insurers about $4,129, or about $12,211 in cash — about the fair price. Located in Maryville, 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	$586 - $4,129	15%
Blue Cross Blue Shieldmajor	$7,036	176%
Aetnamajor	$3,816 - $4,129	95%
Humanamajor	$586 - $4,129	15%
Ambetter (Centene)	$6,084	152%
CareSource	$3,892	97%
+ 4 smaller / regional plans	$4,196 - $10,490

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

Excludes 2 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 12,211), 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 Anderson 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 Anderson Hospital

Compare: Breast lump removal at other IL hospitals

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