CMS Price Transparency Data

Breast lump removal

Facility: McLaren Port Huron

Billing Code: 19120 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$1,941

about 0.5× the $4,000 Medicare rate · typically $502–$4,229

modeled estimate · not a bill or quote

What this hospital charges insurers

$478

Below the fair price — a good deal

about $1,463 under the fair price · 0.1× Medicare

Medicare pays $4,000 Fair price $1,941 This hospital $478 Cash price $511 Hospital's list price $1,021

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

One of the lower prices — 5 of 8 other MI hospitals charge more for the same procedure.

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 $1,941 (about 0.5× the $4,000 Medicare rate). McLaren Port Huron charges insurers about $478, or about $511 in cash — below the fair price — a good deal. Located in Port Huron, MI.

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✓ Humana CignaKaiser 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	$521	13%
Blue Cross Blue Shieldmajor	$680	17%
Aetnamajor	$496	12%
Humanamajor	$400	10%
Priority Health	$549	14%
+ 3 smaller / regional plans	$414 - $460

Government programs also on file: Medicare, Medicaid.

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 511), 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 McLaren Port Huron 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 McLaren Port Huron

Compare: Breast lump removal at other MI hospitals

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