CMS Price Transparency Data

Breast lump removal

Facility: Memorial Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$469

about 0.1× the $4,000 Medicare rate · typically $446–$2,426

modeled estimate · not a bill or quote

What this hospital charges insurers

$469

About the fair price

0.1× Medicare

Medicare pays $4,000 Fair price $469 This hospital $469 Cash price $328 Hospital's list price $469

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

One of the lower prices — 6 of 8 other TX hospitals charge more for the same procedure.

Cheapest $458 Priciest $912

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 $469 (about 0.1× the $4,000 Medicare rate). Memorial Medical Center charges insurers about $469, or about $328 in cash — about the fair price. Located in Port Lavaca, 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	$395 - $691	10%
Blue Cross Blue Shieldmajor	$351 - $375	9%
Aetnamajor	$493	12%
Cignamajor	$514	13%
Humanamajor	$375	9%
Ambetter (Centene)	$150	4%
Amerigroup	$395 - $469	10%
Health Net	$514	13%
Healthcare Highways	$305	8%
Molina	$469	12%
+ 13 smaller / regional plans	$395 - $492

Government programs also on file: Military & VA.

Excludes 9 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 328), 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 Memorial 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 Memorial Medical Center

Compare: Breast lump removal at other TX hospitals

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