CMS Price Transparency Data

Breast lump removal

Facility: South Pointe Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,584

about 0.9× the $4,000 Medicare rate · typically $1,551–$3,789

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,550

About the fair price

about $34 under the fair price · 0.9× Medicare

Medicare pays $4,000 Fair price $3,584 This hospital $3,550 Cash price $5,099 Hospital's list price $7,845

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 $3,550

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

A fair price for a Breast lump removal is about $3,584 (about 0.9× the $4,000 Medicare rate). South Pointe Hospital charges insurers about $3,550, or about $5,099 in cash — about the fair price. Located in Warrensville Heights, OH.

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	$930 - $5,553	23%
Blue Cross Blue Shieldmajor	$1,028 - $6,147	26%
Aetnamajor	$3,550 - $7,845	89%
Cignamajor	$3,656 - $6,276	91%
Humanamajor	$3,550 - $6,668	89%
AmeriHealth	$1,077	27%
CareSource	$1,047	26%
Devoted Health	$3,550	89%
Molina	$1,028	26%
Oscar Health	$2,364 - $3,016	59%
Paramount	$1,008	25%
UniCare	$3,727	93%
UPMC Health Plan	$3,550 - $4,707	89%
+ 16 smaller / regional plans	$1,028 - $7,060

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 5,099), 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 South Pointe 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 South Pointe Hospital

Compare: Breast lump removal at other OH hospitals

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