CMS Price Transparency Data

Breast lump removal

Facility: Garnet Health Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$4,675
about 1.2× the $4,000 Medicare rate · typically $2,699–$8,776
modeled estimate · not a bill or quote
What this hospital charges insurers
$3,545
Below the fair price — a good deal
about $1,130 under the fair price · 0.9× Medicare
Medicare pays $4,000 Fair price $4,675 This hospital $3,545

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 $3,545

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 $4,675 (about 1.2× the $4,000 Medicare rate). Garnet Health Medical Center charges insurers about $3,545 — below the fair price — a good deal. Located in Middletown, 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 $3,262 82%
Blue Cross Blue Shieldmajor $5,377 - $5,501 134%
Aetnamajor $1,335 - $4,888 33%
Cignamajor $3,827 96%
CDPHP $4,881 122%
Fidelis Care $4,985 125%
Geisinger $12,219 305%
MagnaCare $1,213 - $1,940 30%
MVP Health Care $2,108 53%
WellCare $5,000 125%
+ 4 smaller / regional plans $1,335 - $10,020

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Facility Profile & Credentials

  • Address: 707 East Main Street, Middletown, NY 10940
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals