CMS Price Transparency Data

Breast lump removal

Facility: Greater Baltimore Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $564
Cash Discount Price: $1,101
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Greater Baltimore Medical Center is $564. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,101. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.14x the Medicare baseline. Located in 6701 North Charles Street, Baltimore, MD.

Cash / Self-Pay

$1,101

Average discount available for prompt cash payment at this facility.

Insurance Median

$564

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$4,000.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4,000.24 (100%)

Cash / Self-Pay: $1,101 (28%)

Insurance Median: $564 (14%)

Cash: $1,101 (28% of Medicare)

Ins. Median: $564 (14% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4,000.24 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$395 - $562	10%
Md Physician Care [237]	$395	10%
Medicaid / KanCare	$395	10%
Priority Partners [241]	$395	10%
UnitedHealthcare	$395 - $633	10%
Wellpoint [235]	$395	10%
Alterwood Health [290]	$403	10%
Jai Medical Services [236]	$415	10%
Carefirst Maryland Health Advantage Mca [264]	$564	14%
Carefirst [201]	$564 - $663	14%
Cfchp Mco [239]	$564	14%
Cigna	$564 - $686	14%
Communicare Advantage [300]	$564	14%
Humana	$564	14%
Johns Hopkins [213]	$564 - $756	14%
Keycare Advantage [299]	$564	14%
Medicare (plans)	$564	14%
Provider Partners Health Plan [298]	$564	14%
Carefirst Blue Choice Hmo [253]	$629	16%
Carefirst Administrator [252]	$663	17%
First Health Network [268]	$734	18%
Multiplan/Phcs [296]	$734	18%
Kaiser Permanente Hmo [231]	$796	20%
Usa Managed Care Organization [301]	$863	22%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,101.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 19120.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Greater Baltimore Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 19120.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.