CMS Price Transparency Data

Breast lump removal

Facility: Merit Health Madison

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$4,822
about 1.2× the $4,000 Medicare rate · typically $3,108–$6,358
modeled estimate · not a bill or quote
What this hospital charges insurers
$5,383
About the fair price
about $561 over the fair price · 1.3× Medicare
Medicare pays $4,000 Fair price $4,822 This hospital $5,383 Cash price $3,632 Hospital's list price $9,079

How we calculate the fair BaseRate →

How this hospital compares to other MS hospitals

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

Cheapest $449 Priciest $5,383

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

A fair price for a Breast lump removal is about $4,822 (about 1.2× the $4,000 Medicare rate). Merit Health Madison charges insurers about $5,383, or about $3,632 in cash — about the fair price. Located in Canton, MS.

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✓ Cigna✓ Humana AetnaKaiser 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 $2,016 - $2,070 50%
Blue Cross Blue Shieldmajor $5,383 135%
Cignamajor $8,159 204%
Humanamajor $3,676 92%
Ambetter (Centene) $9,079 227%
Devoted Health $3,712 93%
Molina $3,006 - $7,600 75%
WellCare $3,641 91%
+ 6 smaller / regional plans $3,035 - $7,070
Government programs also on file: Medicare.

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Facility Profile & Credentials

  • Address: 161 River Oaks Drive, Canton, MS 39046
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals