CMS Price Transparency Data

Breast lump removal

Facility: Mainehealth Pen Bay Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$1,877
about 0.5× the $4,000 Medicare rate · typically $742–$2,554
modeled estimate · not a bill or quote
What this hospital charges insurers
$824
Below the fair price — a good deal
about $1,053 under the fair price · 0.2× Medicare
Medicare pays $4,000 Fair price $1,877 This hospital $824

How we calculate the fair BaseRate →

How this hospital compares to other ME hospitals

On the higher side — 6 of 8 other ME hospitals charge less.

Cheapest $575 Priciest $844

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

A fair price for a Breast lump removal is about $1,877 (about 0.5× the $4,000 Medicare rate). Mainehealth Pen Bay Hospital charges insurers about $824 — below the fair price — a good deal. Located in Rockport, ME.

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 $458 - $3,706 11%
Blue Cross Blue Shieldmajor $403 - $17,997 10%
Aetnamajor $399 - $3,780 10%
Cignamajor $929 23%
Humanamajor $458 - $3,706 11%
Harvard Pilgrim $1,011 25%
WellCare $411 - $3,817 10%
+ 1 smaller / regional plan $865
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 6 Glen Cove Drive, Rockport, ME 04856
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals