CMS Price Transparency Data

Breast lump removal

Facility: Christus Santa Rosa Hospital-San Marcos

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$3,554

about 0.9× the $4,000 Medicare rate · typically $1,065–$4,300

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,785

About the fair price

about $231 over the fair price · 0.9× Medicare

Medicare pays $4,000 Fair price $3,554 This hospital $3,785

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

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

Cheapest $458 Priciest $3,785

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

A fair price for a Breast lump removal is about $3,554 (about 0.9× the $4,000 Medicare rate). Christus Santa Rosa Hospital-San Marcos charges insurers about $3,785 — about the fair price. Located in San Marcos, TX.

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	$430 - $4,979	11%
Blue Cross Blue Shieldmajor	$983 - $7,604	25%
Aetnamajor	$3,785	95%
Cignamajor	$3,822 - $7,553	96%
Humanamajor	$3,711 - $5,672	93%
Amerigroup	$1,012 - $4,008	25%
Devoted Health	$4,008	100%
Healthcare Highways	$9,389	235%
WellCare	$3,711	93%
+ 10 smaller / regional plans	$964 - $6,346

Government programs also on file: Military & VA.

Excludes 1 rental-network / third-party entry (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 Christus Santa Rosa Hospital-San Marcos 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 Christus Santa Rosa Hospital-San Marcos

Compare: Breast lump removal at other TX hospitals

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