CMS Price Transparency Data

Breast lump removal

Facility: Columbia Memorial Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$546

about 0.1× the $4,000 Medicare rate · typically $406–$1,512

modeled estimate · not a bill or quote

What this hospital charges insurers

$574

About the fair price

about $28 over the fair price · 0.1× Medicare

Medicare pays $4,000 Fair price $546 This hospital $574 Cash price $1,094 Hospital's list price $2,188

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

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

Cheapest $467 Priciest $574

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

A fair price for a Breast lump removal is about $546 (about 0.1× the $4,000 Medicare rate). Columbia Memorial Hospital charges insurers about $574, or about $1,094 in cash — about the fair price. Located in Hudson, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$181 - $3,648	5%
Blue Cross Blue Shieldmajor	$322 - $6,586	8%
Aetnamajor	$466 - $4,667	12%
Cignamajor	$572 - $713	14%
CDPHP	$321 - $4,573	8%
Fidelis Care	$430 - $4,758	11%
MagnaCare	$842 - $4,341	21%
MVP Health Care	$317 - $4,082	8%
+ 5 smaller / regional plans	$423 - $5,638

Government programs also on file: Medicare, Medicaid, Military & VA.

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 1,094), 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 Columbia Memorial Hospital 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 Columbia Memorial Hospital

Compare: Breast lump removal at other NY hospitals

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