CMS Price Transparency Data

Breast lump removal

Facility: Inova Mount Vernon Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$4,987

about 1.2× the $4,000 Medicare rate · typically $3,301–$7,511

modeled estimate · not a bill or quote

What this hospital charges insurers

$5,716

About the fair price

about $729 over the fair price · 1.4× Medicare

Medicare pays $4,000 Fair price $4,987 This hospital $5,716

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

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

Cheapest $3,225 Priciest $5,716

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

A fair price for a Breast lump removal is about $4,987 (about 1.2× the $4,000 Medicare rate). Inova Mount Vernon Hospital charges insurers about $5,716 — about the fair price. Located in Alexandria, VA.

What each insurance company pays

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

6 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	$1,948 - $9,238	49%
Blue Cross Blue Shieldmajor	$1,910 - $15,361	48%
Aetnamajor	$2,005 - $8,932	50%
Cignamajor	$3,982 - $8,534	100%
Humanamajor	$1,986 - $6,318	50%
Kaiser Permanentemajor	$2,101 - $5,974	53%
Sentara	$1,967 - $7,609	49%
+ 1 smaller / regional plan	$3,508 - $6,340

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 Inova Mount Vernon 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 Inova Mount Vernon Hospital

Compare: Breast lump removal at other VA hospitals

Medical College of Virginia Hospitals · Richmond $3,225
Mary Washington Hospital · Fredericksburg $3,632
Stafford Hospital, LLC · Stafford $3,632
Vcu Health Tappahannock Hospital · Tappahannock $3,656
Community Memorial Hospital · South Hill $3,656
Bon Secours Maryview Medical Center · Portsmouth $3,820
Mary Immaculate Hospital · Newport News $3,820
Bon Secours Southside Medical Center · Petersburg $3,820

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