CMS Price Transparency Data

Breast lump removal

Facility: Essentia Health St Marys - Detroit Lakes

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$4,044

about 1.0× the $4,000 Medicare rate · typically $3,171–$4,044

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,025

About the fair price

about $19 under the fair price · 1.0× Medicare

Medicare pays $4,000 Fair price $4,044 This hospital $4,025 Cash price $2,978 Hospital's list price $4,639

How we calculate the fair BaseRate →

How this hospital compares to other MN hospitals

Highest price of the 9 MN hospitals we have prices for — worth calling around.

Cheapest $452 Priciest $4,025

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

A fair price for a Breast lump removal is about $4,044 (about 1.0× the $4,000 Medicare rate). Essentia Health St Marys - Detroit Lakes charges insurers about $4,025, or about $2,978 in cash — about the fair price. Located in Detroit Lakes, MN.

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	$3,897 - $4,025	97%
Blue Cross Blue Shieldmajor	$2,088 - $16,780	52%
Aetnamajor	$3,943	99%
Cignamajor	$3,405	85%
HealthPartners	$1,805 - $4,025	45%
Medica	$2,950 - $4,025	74%
Sanford Health Plan	$1,990 - $6,781	50%
Security Health Plan	$4,025	101%
UCare	$3,052 - $4,025	76%
+ 12 smaller / regional plans	$3,340 - $4,025

Government programs also on file: Medicare.

Excludes 2 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 (about 2,978), 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 Essentia Health St Marys - Detroit Lakes 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 Essentia Health St Marys - Detroit Lakes

Compare: Breast lump removal at other MN hospitals

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