CMS Price Transparency Data

Breast lump removal

Facility: Lafollette Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,523

about 0.9× the $4,000 Medicare rate · typically $2,164–$3,631

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,819

About the fair price

about $296 over the fair price · 1.0× Medicare

Medicare pays $4,000 Fair price $3,523 This hospital $3,819 Cash price $6,177 Hospital's list price $22,877

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Highest price of the 9 TN hospitals we have prices for — worth calling around.

Cheapest $502 Priciest $3,819

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 $3,523 (about 0.9× the $4,000 Medicare rate). Lafollette Medical Center charges insurers about $3,819, or about $6,177 in cash — about the fair price. Located in La Follette, 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	$1,753 - $22,877	44%
Blue Cross Blue Shieldmajor	$1,089 - $6,243	27%
Aetnamajor	$3,856 - $14,229	96%
Cignamajor	$13,446	336%
Humanamajor	$3,744 - $5,033	94%
Ambetter (Centene)	$7,038	176%
Amerigroup	$2,120 - $3,931	53%
Cigna HealthSpring	$3,856	96%
Devoted Health	$3,819	95%
WellCare	$3,805 - $5,719	95%
+ 10 smaller / regional plans	$373 - $8,370

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 3 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 6,177), 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 Lafollette Medical Center 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 Lafollette Medical Center

Compare: Breast lump removal at other TN hospitals

Williamson Medical Center · Franklin $502
Erlanger Medical Center · Chattanooga $751
University Health System, Inc · Knoxville $819
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

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