CMS Price Transparency Data

Breast lump removal

Facility: Houlton Regional Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$974

about 0.2× the $4,000 Medicare rate · typically $482–$3,259

modeled estimate · not a bill or quote

What this hospital charges insurers

$614

Below the fair price — a good deal

about $360 under the fair price · 0.2× Medicare

Medicare pays $4,000 Fair price $974 This hospital $614 Cash price $2,268 Hospital's list price $2,387

How we calculate the fair BaseRate →

How this hospital compares to other ME hospitals

One of the lower prices — 7 of 8 other ME hospitals charge more for the same procedure.

Cheapest $575 Priciest $844

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Breast lump removal is about $974 (about 0.2× the $4,000 Medicare rate). Houlton Regional Hospital charges insurers about $614, or about $2,268 in cash — below the fair price — a good deal. Located in Houlton, ME.

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	$2,268	57%
Blue Cross Blue Shieldmajor	$592 - $2,012	15%
Aetnamajor	$620	15%
Cignamajor	$2,172	54%
WellCare	$614	15%
+ 2 smaller / regional plans	$1,217 - $2,101

Government programs also on file: 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 2,268), 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 Houlton Regional 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 Houlton Regional Hospital

Compare: Breast lump removal at other ME hospitals

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