CMS Price Transparency Data

Breast lump removal

Facility: Erlanger Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$876

about 0.2× the $4,000 Medicare rate · typically $649–$1,864

modeled estimate · not a bill or quote

What this hospital charges insurers

$751

Below the fair price — a good deal

about $125 under the fair price · 0.2× Medicare

Medicare pays $4,000 Fair price $876 This hospital $751 Cash price $480 Hospital's list price $909

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

One of the lower prices — 7 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 $876 (about 0.2× the $4,000 Medicare rate). Erlanger Medical Center charges insurers about $751, or about $480 in cash — below the fair price — a good deal. Located in Chattanooga, 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	$343 - $3,950	9%
Blue Cross Blue Shieldmajor	$351 - $3,513	9%
Aetnamajor	$540 - $3,618	13%
Cignamajor	$389 - $3,513	10%
Humanamajor	$392 - $3,513	10%
Ambetter (Centene)	$671 - $4,391	17%
Amerigroup	$306 - $1,113	8%
CareSource	$306 - $7,025	8%
Clover Health	$537 - $3,513	13%
Devoted Health	$559 - $3,653	14%
UPMC Health Plan	$537 - $3,513	13%
+ 13 smaller / regional plans	$291 - $8,782

Government programs also on file: Medicare, Medicaid.

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 480), 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 Erlanger 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 Erlanger Medical Center

Compare: Breast lump removal at other TN hospitals

Williamson Medical Center · Franklin $502
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
Ascension Saint Thomas Hospital · Nashville $1,706

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