CMS Price Transparency Data

Breast lump removal

Facility: SSM Health Depaul Hospital St Louis

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$2,517

about 0.6× the $4,000 Medicare rate · typically $1,337–$3,987

modeled estimate · not a bill or quote

What this hospital charges insurers

$2,144

Below the fair price — a good deal

about $373 under the fair price · 0.5× Medicare

Medicare pays $4,000 Fair price $2,517 This hospital $2,144 Cash price $3,502 Hospital's list price $6,368

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

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

Cheapest $445 Priciest $2,144

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

A fair price for a Breast lump removal is about $2,517 (about 0.6× the $4,000 Medicare rate). SSM Health Depaul Hospital St Louis charges insurers about $2,144, or about $3,502 in cash — below the fair price — a good deal. Located in Bridgeton, MO.

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	$2,727 - $3,980	68%
Blue Cross Blue Shieldmajor	$438 - $3,981	11%
Aetnamajor	$2,224 - $4,059	56%
Cignamajor	$3,071	77%
Humanamajor	$3,988	100%
Ambetter (Centene)	$2,167	54%
HealthLink	$1,865 - $3,102	47%
Oscar Health	$3,886 - $4,706	97%

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 3,502), 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 SSM Health Depaul Hospital St Louis 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 SSM Health Depaul Hospital St Louis

Compare: Breast lump removal at other MO hospitals

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