CMS Price Transparency Data

Breast lump removal

Facility: Mercy Health-Anderson Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$5,150

about 1.3× the $4,000 Medicare rate · typically $3,819–$7,360

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,816

Below the fair price — a good deal

about $1,334 under the fair price · 1.0× Medicare

Medicare pays $4,000 Fair price $5,150 This hospital $3,816 Cash price $12,211 Hospital's list price $20,351

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

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

Cheapest $479 Priciest $3,816

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Breast lump removal is about $5,150 (about 1.3× the $4,000 Medicare rate). Mercy Health-Anderson Hospital charges insurers about $3,816, or about $12,211 in cash — below the fair price — a good deal. Located in Cincinnati, OH.

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✓ Aetna✓ Humana Blue Cross Blue ShieldCignaKaiser 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	$3,816	95%
Aetnamajor	$3,816	95%
Humanamajor	$3,816	95%
CareSource	$3,892	97%

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 12,211), 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 Mercy Health-Anderson 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 Mercy Health-Anderson Hospital

Compare: Breast lump removal at other OH hospitals

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