CMS Price Transparency Data

Breast lump removal

Facility: South County Hospital Inc

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$4,887

about 1.2× the $4,000 Medicare rate · typically $1,961–$6,500

modeled estimate · not a bill or quote

What this hospital charges insurers

$2,194

Below the fair price — a good deal

about $2,693 under the fair price · 0.5× Medicare

Medicare pays $4,000 Fair price $4,887 This hospital $2,194 Cash price $3,896 Hospital's list price $6,493

How we calculate the fair BaseRate →

How this hospital compares to other RI hospitals

Lowest price of the 5 RI hospitals we have prices for — a strong deal.

Cheapest $2,194 Priciest $7,401

Black dot = this hospital, among the 5 RI hospitals with a price for this procedure. Full list below.

A fair price for a Breast lump removal is about $4,887 (about 1.2× the $4,000 Medicare rate). South County Hospital Inc charges insurers about $2,194, or about $3,896 in cash — below the fair price — a good deal. Located in Wakefield, RI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

1 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare Blue Cross Blue ShieldAetnaCignaHumanaKaiser 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	$1,108	28%
Tufts Health Plan	$3,276	82%
+ 1 smaller / regional plan	$3,750

Excludes 1 rental-network / third-party entry (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 3,896), 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 County Hospital Inc 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 County Hospital Inc

Compare: Breast lump removal at other RI hospitals

Landmark Medical Center · Woonsocket $4,381
Rhode Island Hospital · Providence $6,702
Newport Hospital · Newport $6,757
The Miriam Hospital · Providence $7,401

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