CMS Price Transparency Data
Breast lump removal
Facility: Mount Carmel East & West
Billing Code: 19120 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$3,255
about 0.8× the $4,000 Medicare rate · typically $1,549–$9,477
modeled estimate · not a bill or quote
Medicare pays $4,000 Fair price $3,255 Cash price $4,153 Hospital's list price $5,324
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 | $3,703 - $8,089 | 93% |
| Blue Cross Blue Shieldmajor | $3,630 - $14,083 | 91% |
| Aetnamajor | $1,912 - $6,389 | 48% |
| Cignamajor | $4,382 | 110% |
| Humanamajor | $2,178 - $6,389 | 54% |
| AmeriHealth | $1,989 - $2,984 | 50% |
| CareSource | $3,109 - $4,664 | 78% |
| GEHA | $1,912 - $8,089 | 48% |
| HealthLink | $3,194 - $4,792 | 80% |
| HealthPartners | $4,382 | 110% |
| MagnaCare | $1,989 - $2,984 | 50% |
| Medical Mutual | $3,241 - $12,885 | 81% |
| MVP Health Care | $4,382 | 110% |
| Oscar Health | $6,112 | 153% |
| Priority Health | $4,382 | 110% |
| Sentara | $4,259 - $6,389 | 106% |
| UniCare | $1,989 - $2,984 | 50% |
| + 90 smaller / regional plans | $632 - $14,083 |
Government programs also on file: Medicare, Medicaid.
Excludes 7 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Mount Carmel East & West
Compare: Breast lump removal at other OH hospitals
- Southern Ohio Medical Center · Portsmouth $479
- Arthur G James Cancer Hospital and Research Institute · Columbus $501
- Fisher-Titus Hospital · Norwalk $522
- Genesis Hospital · Zanesville $594
- Union Hospital · Dover $619
- Southwest General Health Center · Middleburg Heights $669
- Mercy Medical Center · Canton $765
- Akron General Medical Center · Akron $855
Insurance negotiated median for the same procedure, sorted lowest first.