CMS Price Transparency Data

Breast lump removal

Facility: Memorial Hermann Houston Physicians Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$2,181

about 0.5× the $4,000 Medicare rate · typically $1,706–$4,080

modeled estimate · not a bill or quote

Medicare pays $4,000 Fair price $2,181 Cash price $7,512 Hospital's list price $13,444

How we calculate the fair BaseRate →

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	$3,835 - $10,806	96%
Blue Cross Blue Shieldmajor	$3,835 - $10,806	96%
Aetnamajor	$1,410 - $18,374	35%
Cignamajor	$2,704 - $22,109	68%
Humanamajor	$3,835 - $10,806	96%
Devoted Health	$3,835 - $9,823	96%
UniCare	$3,835 - $9,823	96%
WellCare	$3,835 - $9,823	96%
+ 12 smaller / regional plans	$3,835 - $10,806

Government programs also on file: Medicare, Military & VA.

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 7,512), 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 Hermann Houston Physicians Hospital 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 Hermann Houston Physicians Hospital

Compare: Breast lump removal at other TX hospitals

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