CMS Price Transparency Data

Breast lump removal

Facility: Texas Health Center for Diagnostics & Surgery Plan

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$3,759

about 0.9× the $4,000 Medicare rate · typically $2,667–$4,031

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,867

About the fair price

about $108 over the fair price · 1.0× Medicare

Medicare pays $4,000 Fair price $3,759 This hospital $3,867

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 $3,867

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 $3,759 (about 0.9× the $4,000 Medicare rate). Texas Health Center for Diagnostics & Surgery Plan charges insurers about $3,867 — about the fair price. Located in Plano, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Humana AetnaCignaKaiser 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	$964 - $6,494	24%
Blue Cross Blue Shieldmajor	$964 - $25,315	24%
Humanamajor	$3,830	96%
Amerigroup	$964 - $3,867	24%
Cigna HealthSpring	$3,756	94%
Molina	$1,041 - $3,867	26%
WellCare	$1,012 - $4,051	25%
+ 3 smaller / regional plans	$964 - $4,013

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 Texas Health Center for Diagnostics & Surgery Plan 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 Texas Health Center for Diagnostics & Surgery Plan

Compare: Breast lump removal at other TX hospitals

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