CMS Price Transparency Data

Breast lump removal

Facility: St James Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$617
about 0.2× the $4,000 Medicare rate · typically $490–$2,295
modeled estimate · not a bill or quote
What this hospital charges insurers
$488
Below the fair price — a good deal
about $129 under the fair price · 0.1× Medicare
Medicare pays $4,000 Fair price $617 This hospital $488

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

A typical price — 4 charge more and 3 charge less, among the 9 NY hospitals compared.

Cheapest $467 Priciest $533

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 $617 (about 0.2× the $4,000 Medicare rate). St James Hospital charges insurers about $488 — below the fair price — a good deal. Located in Hornell, NY.

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 $359 - $5,235 9%
Blue Cross Blue Shieldmajor $153 - $11,702 4%
Aetnamajor $321 - $5,235 8%
Cignamajor $491 - $11,773 12%
Humanamajor $5,235 131%
CDPHP $1,018 - $1,267 25%
Fidelis Care $304 - $443 8%
MVP Health Care $356 - $11,364 9%
+ 1 smaller / regional plan $11,045
Government programs also on file: Medicare, Medicaid.

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Facility Profile & Credentials

  • Address: 411 Canisteo Street, Hornell, NY 14843
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals