CMS Price Transparency Data

Breast lump removal

Facility: Presbyterian Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$5,742
about 1.4× the $4,000 Medicare rate · typically $3,840–$7,317
modeled estimate · not a bill or quote
What this hospital charges insurers
$6,783
Above the fair price
about $1,041 over the fair price · 1.7× Medicare
Medicare pays $4,000 Fair price $5,742 This hospital $6,783

How we calculate the fair BaseRate →

How this hospital compares to other NM hospitals

On the higher side — 6 of 8 other NM hospitals charge less.

Cheapest $3,857 Priciest $12,791

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

A fair price for a Breast lump removal is about $5,742 (about 1.4× the $4,000 Medicare rate). Presbyterian Hospital charges insurers about $6,783 — above the fair price. Located in Albuquerque, NM.

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 $5,742. 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.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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 $17,197 430%
Blue Cross Blue Shieldmajor $4,031 - $6,783 101%
Aetnamajor $4,070 102%
Presbyterian $3,876 - $9,004 97%

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: 1100 Central Avenue Se, Albuquerque, NM 87106
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals