CMS Price Transparency Data

Breast lump removal

Facility: Providence Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$4,038

about 1.0× the $4,000 Medicare rate · typically $1,511–$5,846

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,873

About the fair price

about $165 under the fair price · 1.0× Medicare

Medicare pays $4,000 Fair price $4,038 This hospital $3,873 Cash price $3,688 Hospital's list price $7,131

How we calculate the fair BaseRate →

How this hospital compares to other KS hospitals

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

Cheapest $448 Priciest $3,873

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

A fair price for a Breast lump removal is about $4,038 (about 1.0× the $4,000 Medicare rate). Providence Medical Center charges insurers about $3,873, or about $3,688 in cash — about the fair price. Located in Kansas City, KS.

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✓ Cigna HumanaKaiser 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	$1,235 - $5,164	31%
Blue Cross Blue Shieldmajor	$5,902 - $6,824	148%
Aetnamajor	$601 - $3,689	15%
Cignamajor	$3,689	92%
+ 12 smaller / regional plans	$496 - $5,902

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.

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 3,688), 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 Providence 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 Providence Medical Center

Compare: Breast lump removal at other KS hospitals

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