CMS Price Transparency Data

Breast lump removal

Facility: Pender Memorial Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$1,374
about 0.3× the $4,000 Medicare rate · typically $720–$3,017
modeled estimate · not a bill or quote
What this hospital charges insurers
$5,349
Well above the fair price
about $3,975 over the fair price · 1.3× Medicare
Medicare pays $4,000 Fair price $1,374 This hospital $5,349 Cash price $3,883 Hospital's list price $8,628

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 $5,349

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 $1,374 (about 0.3× the $4,000 Medicare rate). Pender Memorial Hospital charges insurers about $5,349, or about $3,883 in cash — well above the fair price. Located in Burgaw, NC.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $1,374. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 $6,298 157%
Blue Cross Blue Shieldmajor $2,330 - $6,212 58%
Aetnamajor $2,388 - $7,334 60%
Cignamajor $2,399 - $3,805 60%
Humanamajor $2,213 - $7,420 55%
Ambetter (Centene) $3,261 82%
AmeriHealth $2,472 62%
CareSource $3,451 86%
WellCare $2,472 62%
+ 7 smaller / regional plans $2,330 - $8,369
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 507 E Fremont St, Burgaw, NC 28425
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals