CMS Price Transparency Data

Breast lump removal

Facility: Robert Wood Johnson University Hospital at Hamilton

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$5,272

about 1.3× the $4,000 Medicare rate · typically $3,813–$5,992

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,269

Below the fair price — a good deal

about $1,003 under the fair price · 1.1× Medicare

Medicare pays $4,000 Fair price $5,272 This hospital $4,269 Cash price $5,110 Hospital's list price $7,365

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

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

Cheapest $808 Priciest $4,269

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 $5,272 (about 1.3× the $4,000 Medicare rate). Robert Wood Johnson University Hospital at Hamilton charges insurers about $4,269, or about $5,110 in cash — below the fair price — a good deal. Located in Hamilton, 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	$896 - $4,759	22%
Blue Cross Blue Shieldmajor	$284 - $18,515	7%
Aetnamajor	$981 - $5,845	25%
Cignamajor	$3,883 - $5,197	97%
Humanamajor	$4,185	105%
AmeriHealth	$5,363 - $5,644	134%
Clover Health	$4,185	105%
Fidelis Care	$921 - $4,185	23%
WellCare	$8,328	208%
+ 1 smaller / regional plan	$7,324

Excludes 1 rental-network / third-party entry (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 5,110), 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 Robert Wood Johnson University Hospital at Hamilton 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 Robert Wood Johnson University Hospital at Hamilton

Compare: Breast lump removal at other NJ hospitals

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