CMS Price Transparency Data

Breast lump removal

Facility: St Anthony Community Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$6,717
about 1.7× the $4,000 Medicare rate · typically $2,784–$10,410
modeled estimate · not a bill or quote
What this hospital charges insurers
$7,230
About the fair price
about $513 over the fair price · 1.8× Medicare
Medicare pays $4,000 Fair price $6,717 This hospital $7,230

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 $7,230

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 $6,717 (about 1.7× the $4,000 Medicare rate). St Anthony Community Hospital charges insurers about $7,230 — about the fair price. Located in Warwick, 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 $6,146 - $7,230 154%
Blue Cross Blue Shieldmajor $10,414 - $12,827 260%
Aetnamajor $7,072 - $7,858 177%
Cignamajor $6,274 157%
Geisinger $16,050 401%
MagnaCare $8,760 219%
Molina $5,107 128%
MVP Health Care $4,864 - $12,212 122%
+ 5 smaller / regional plans $4,864 - $6,146
Government programs also on file: Medicare, Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals