CMS Price Transparency Data

Breast lump removal

Facility: M Health Fairview University of Mn Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,571
  • Cash Discount Price: $4,120
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at M Health Fairview University of Mn Medical Center is $3,571. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,120. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.89x the Medicare baseline. Located in 2450 Riverside Avenue, Minneapolis, MN.
Cash / Self-Pay
$4,120

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,571

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: $4,120 (103%)
Insurance Median: $3,571 (89%)
Cash: $4,120 (103% of Medicare)
Ins. Median: $3,571 (89% 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.

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
Health Partners $279 - $13,443 7%
Itasca Medical Care $279 - $3,812 7%
Primewest $279 - $3,812 7%
South Country Health Alliance $279 - $3,812 7%
Ucare $284 - $8,759 7%
Medica $297 - $4,040 7%
Hennepin Health $315 - $3,857 8%
Blue Cross Blue Shield $318 - $3,964 8%
Sanford Health Plan $378 - $6,052 9%
Security Health Plan $378 - $7,706 9%
UnitedHealthcare $378 - $5,857 9%
Wellcare $378 - $3,812 9%
America'S Ppo $5,353 - $7,398 134%
Cigna $5,754 144%
Emerging Therapies $6,576 164%
Humana $6,679 167%
Aetna $6,987 175%
Interlink $7,706 193%
First Health $8,426 211%
Multiplan $8,734 218%
Private Healthcare Systems $8,734 218%
Wisconsin Physician Services $9,248 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2450 Riverside Avenue, Minneapolis, MN 55454
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals