CMS Price Transparency Data

Breast lump removal

Facility: SSM Health Saint Louis University Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,466

about 0.6× the $4,000 Medicare rate · typically $1,170–$4,126

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,667

Below the fair price — a good deal

about $799 under the fair price · 0.4× Medicare

Medicare pays $4,000 Fair price $2,466 This hospital $1,667

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 $1,667

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 $2,466 (about 0.6× the $4,000 Medicare rate). SSM Health Saint Louis University Hospital charges insurers about $1,667 — below the fair price — a good deal. Located in Saint Louis, 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	$3,241 - $4,332	81%
Blue Cross Blue Shieldmajor	$503 - $3,843	13%
Aetnamajor	$1,889 - $4,000	47%
Cignamajor	$1,833	46%
Humanamajor	$3,988	100%
Ambetter (Centene)	$3,148 - $3,961	79%
HealthLink	$2,496 - $3,851	62%
Oscar Health	$3,886 - $4,706	97%
+ 1 smaller / regional plan	$4,039

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 SSM Health Saint Louis University 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 SSM Health Saint Louis University Hospital

Compare: Breast lump removal at other MO hospitals

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