CMS Price Transparency Data

Breast lump removal

Facility: Sanford Usd Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$3,921
about 1.0× the $4,000 Medicare rate · typically $2,812–$3,950
modeled estimate · not a bill or quote
What this hospital charges insurers
$3,944
About the fair price
about $23 over the fair price · 1.0× Medicare
Medicare pays $4,000 Fair price $3,921 This hospital $3,944

How we calculate the fair BaseRate →

How this hospital compares to other SD hospitals

A typical price — 1 charge more and 3 charge less, among the 6 SD hospitals compared.

Cheapest $1,043 Priciest $4,293

Black dot = this hospital, among the 6 SD hospitals with a price for this procedure. Full list below.

A fair price for a Breast lump removal is about $3,921 (about 1.0× the $4,000 Medicare rate). Sanford Usd Medical Center charges insurers about $3,944 — about the fair price. Located in Sioux Falls, SD.

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✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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 $3,944 99%
Blue Cross Blue Shieldmajor $1,689 - $7,191 42%
Aetnamajor $3,944 99%
HealthPartners $3,944 99%
Sanford Health Plan $421 - $3,638 11%
UCare $3,906 - $3,995 98%
+ 1 smaller / regional plan $3,995 - $4,021
Government programs also on file: Medicare.

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Facility Profile & Credentials

  • Address: 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD 57117
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals