CMS Price Transparency Data

Breast lump removal

Facility: Hiawatha Community Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$657

about 0.2× the $4,000 Medicare rate · typically $438–$2,384

modeled estimate · not a bill or quote

What this hospital charges insurers

$552

Below the fair price — a good deal

about $105 under the fair price · 0.1× Medicare

Medicare pays $4,000 Fair price $657 This hospital $552 Cash price $875 Hospital's list price $875

How we calculate the fair BaseRate →

How this hospital compares to other KS hospitals

A typical price — 5 charge more and 3 charge less, among the 9 KS hospitals compared.

Cheapest $448 Priciest $627

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 $657 (about 0.2× the $4,000 Medicare rate). Hiawatha Community Hospital charges insurers about $552, or about $875 in cash — below the fair price — a good deal. Located in Hiawatha, 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✓ Aetna✓ Cigna✓ Humana Blue Cross Blue ShieldKaiser 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	$368 - $526	9%
Aetnamajor	$368 - $562	9%
Cignamajor	$720	18%
Humanamajor	$368	9%
Ambetter (Centene)	$341	9%
Oscar Health	$588	15%
+ 4 smaller / regional plans	$441 - $947

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 875), 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 Hiawatha Community 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 Hiawatha Community Hospital

Compare: Breast lump removal at other KS hospitals

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