CMS Price Transparency Data

Breast lump removal

Facility: Carolina East Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$744

about 0.2× the $4,000 Medicare rate · typically $354–$4,813

modeled estimate · not a bill or quote

Medicare pays $4,000 Fair price $744 Cash price $907 Hospital's list price $1,512

How we calculate the fair BaseRate →

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	$529	13%
Blue Cross Blue Shieldmajor	$1,056	26%
Aetnamajor	$1,340	33%
Cignamajor	$1,376	34%
Humanamajor	$379	9%
+ 5 smaller / regional plans	$379 - $1,366

Government programs also on file: Military & VA.

Excludes 6 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 907), 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 Carolina East Medical Center 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 Carolina East Medical Center

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.