CMS Price Transparency Data

Breast lump removal

Facility: Henry Ford Health Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$503

about 0.1× the $4,000 Medicare rate · typically $146–$1,469

modeled estimate · not a bill or quote

What this hospital charges insurers

$500

About the fair price

about $3 under the fair price · 0.1× Medicare

Medicare pays $4,000 Fair price $503 This hospital $500 Hospital's list price $2,359

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

A typical price — 3 charge more and 4 charge less, among the 9 MI hospitals compared.

Cheapest $445 Priciest $521

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

A fair price for a Breast lump removal is about $503 (about 0.1× the $4,000 Medicare rate). Henry Ford Health Hospital charges insurers about $500 — about the fair price. Located in Detroit, MI.

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	$445 - $3,752	11%
Blue Cross Blue Shieldmajor	$260 - $3,752	6%
Aetnamajor	$238 - $4,127	6%
Cignamajor	$724 - $2,243	18%
Humanamajor	$367 - $3,328	9%
AmeriHealth	$272 - $3,677	7%
CareSource	$272 - $3,752	7%
Meridian	$238 - $3,328	6%
Molina	$283 - $3,752	7%
Priority Health	$238 - $3,752	6%
WellCare	$445 - $3,789	11%
+ 15 smaller / regional plans	$238 - $8,629

Excludes 3 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, 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 Henry Ford Health 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 Henry Ford Health Hospital

Compare: Breast lump removal at other MI hospitals

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