CMS Price Transparency Data

Breast lump removal

Facility: North Carolina Baptist Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,659

about 0.9× the $4,000 Medicare rate · typically $2,962–$3,744

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,707

About the fair price

about $48 over the fair price · 0.9× Medicare

Medicare pays $4,000 Fair price $3,659 This hospital $3,707 Cash price $2,470 Hospital's list price $4,940

How we calculate the fair BaseRate →

How this hospital compares to other NC hospitals

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

Cheapest $469 Priciest $3,707

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

A fair price for a Breast lump removal is about $3,659 (about 0.9× the $4,000 Medicare rate). North Carolina Baptist Hospital charges insurers about $3,707, or about $2,470 in cash — about the fair price. Located in Winston-Salem, NC.

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	$1,100 - $4,925	27%
Blue Cross Blue Shieldmajor	$810 - $3,707	20%
Aetnamajor	$1,139 - $4,311	28%
Cignamajor	$1,471 - $3,707	37%
Humanamajor	$2,629 - $3,744	66%
Ambetter (Centene)	$1,298 - $1,369	32%
AmeriHealth	$1,086 - $1,367	27%
Devoted Health	$3,707	93%
Oscar Health	$1,442 - $1,826	36%
WellCare	$1,100 - $3,707	27%
+ 13 smaller / regional plans	$1,086 - $4,263

Government programs also on file: Medicare.

Excludes 3 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 2,470), 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 North Carolina Baptist 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 North Carolina Baptist Hospital

Compare: Breast lump removal at other NC hospitals

Hugh Chatham Memorial Hospital · Elkin $469
Duke University Hospital · Durham $565
Angel Medical Center · Franklin $2,800
Frye Regional Medical Center · Hickory $3,214
Central Carolina Hospital · Sanford $3,425
Columbus Regional Healthcare System · Whiteville $3,610
Wakemed, Raleigh Campus · Raleigh $3,702
Wakemed, Cary Hospital · Cary $3,702

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