CMS Price Transparency Data

Breast lump removal

Facility: University Health System, Inc

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,888

about 0.7× the $4,000 Medicare rate · typically $1,140–$3,638

modeled estimate · not a bill or quote

What this hospital charges insurers

$819

Below the fair price — a good deal

about $2,069 under the fair price · 0.2× Medicare

Medicare pays $4,000 Fair price $2,888 This hospital $819

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

One of the lower prices — 6 of 8 other TN hospitals charge more for the same procedure.

Cheapest $502 Priciest $1,706

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

A fair price for a Breast lump removal is about $2,888 (about 0.7× the $4,000 Medicare rate). University Health System, Inc charges insurers about $819 — below the fair price — a good deal. Located in Knoxville, TN.

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	$366 - $4,184	9%
Blue Cross Blue Shieldmajor	$316 - $3,706	8%
Aetnamajor	$381 - $3,636	10%
Cignamajor	$384 - $3,497	10%
Humanamajor	$381 - $3,497	10%
Devoted Health	$3,636	91%
WellCare	$3,671	92%
+ 6 smaller / regional plans	$338 - $3,706

Government programs also on file: Medicare, Medicaid.

Excludes 2 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, 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 University Health System, 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 University Health System, Inc

Compare: Breast lump removal at other TN hospitals

Williamson Medical Center · Franklin $502
Erlanger Medical Center · Chattanooga $751
Dekalb Community Hospital · Smithville $1,509
Saint Thomas Highlands Hospital · Sparta $1,509
Stones River Hospital · Woodbury $1,535
Saint Thomas Hickman Hospital · Centerville $1,535
Saint Thomas Rutherford Hospital · Murfreesboro $1,706
Ascension Saint Thomas Hospital · Nashville $1,706

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