CMS Price Transparency Data

Breast lump removal

Facility: Community Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$4,322
about 1.1× the $4,000 Medicare rate · typically $2,845–$5,099
modeled estimate · not a bill or quote
What this hospital charges insurers
$4,185
About the fair price
about $137 under the fair price · 1.0× Medicare
Medicare pays $4,000 Fair price $4,322 This hospital $4,185 Cash price $3,786 Hospital's list price $7,365

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

A typical price — 0 charge more and 3 charge less, among the 9 NJ hospitals compared.

Cheapest $808 Priciest $4,185

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

A fair price for a Breast lump removal is about $4,322 (about 1.1× the $4,000 Medicare rate). Community Medical Center charges insurers about $4,185, or about $3,786 in cash — about the fair price. Located in Toms River, NJ.

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 $914 - $5,045 23%
Blue Cross Blue Shieldmajor $306 - $6,738 8%
Aetnamajor $1,000 - $5,845 25%
Cignamajor $3,102 - $4,151 78%
Humanamajor $4,185 105%
AmeriHealth $5,396 - $5,762 135%
Clover Health $4,185 105%
Fidelis Care $931 - $4,185 23%
WellCare $8,328 208%
+ 2 smaller / regional plans $4,148 - $7,324
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 99 Rt 37 West, Toms River, NJ 08755
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals