CMS Price Transparency Data

Breast lump removal

Facility: Physicians Regional Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$3,045
about 0.8× the $4,000 Medicare rate · typically $1,276–$3,954
modeled estimate · not a bill or quote
What this hospital charges insurers
$3,600
Above the fair price
about $555 over the fair price · 0.9× Medicare
Medicare pays $4,000 Fair price $3,045 This hospital $3,600 Cash price $4,714 Hospital's list price $21,230

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 $3,600

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 $3,045 (about 0.8× the $4,000 Medicare rate). Physicians Regional Medical Center charges insurers about $3,600, or about $4,714 in cash — above the fair price. Located in Powell, TN.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $3,045. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 $1,641 - $21,121 41%
Blue Cross Blue Shieldmajor $994 - $6,090 25%
Aetnamajor $2,089 - $3,600 52%
Cignamajor $8,041 - $8,193 201%
Humanamajor $3,496 87%
Ambetter (Centene) $6,572 164%
Amerigroup $1,991 - $3,670 50%
Cigna HealthSpring $3,600 90%
Devoted Health $3,565 89%
WellCare $3,694 92%
+ 9 smaller / regional plans $373 - $6,572
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals