CMS Price Transparency Data

Breast lump removal

Facility: Boston Medical Center-Brighton

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$4,685

about 1.2× the $4,000 Medicare rate · typically $1,902–$5,502

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,692

About the fair price

about $7 over the fair price · 1.2× Medicare

Medicare pays $4,000 Fair price $4,685 This hospital $4,692 Cash price $2,975 Hospital's list price $6,611

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

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

Cheapest $922 Priciest $4,692

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

A fair price for a Breast lump removal is about $4,685 (about 1.2× the $4,000 Medicare rate). Boston Medical Center-Brighton charges insurers about $4,692, or about $2,975 in cash — about the fair price. Located in Brighton, MA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$4,692	117%
Blue Cross Blue Shieldmajor	$3,220 - $4,959	80%
Aetnamajor	$4,692 - $4,836	117%
Cignamajor	$7,200	180%
Humanamajor	$4,692	117%
Harvard Pilgrim	$2,188	55%
Tufts Health Plan	$7,200	180%
UniCare	$4,959	124%
+ 13 smaller / regional plans	$475 - $6,100

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

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 2,975), 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 Boston Medical Center-Brighton 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 Boston Medical Center-Brighton

Compare: Breast lump removal at other MA hospitals

Metrowest Medical Center · Framingham $922
St Vincent Hospital · Worcester $922
Brigham and Women's Hospital · Boston $2,534
Cambridge Health Alliance · Cambridge $3,220
Beth Israel Deaconess Hospital - Milton · Milton $3,350
Brigham and Women Faulkner Hospital · Jamaica Plain $3,682
South Shore Hospital · South Weymouth $3,956
Emerson Hospital - · W Concord $4,000

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