CMS Price Transparency Data

Breast lump removal

Facility: Multicare Valley Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$5,202

about 1.3× the $4,000 Medicare rate · typically $3,836–$7,345

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,843

About the fair price

about $359 under the fair price · 1.2× Medicare

Medicare pays $4,000 Fair price $5,202 This hospital $4,843 Cash price $5,534 Hospital's list price $13,835

How we calculate the fair BaseRate →

How this hospital compares to other WA hospitals

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

Cheapest $457 Priciest $4,843

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

A fair price for a Breast lump removal is about $5,202 (about 1.3× the $4,000 Medicare rate). Multicare Valley Hospital charges insurers about $4,843, or about $5,534 in cash — about the fair price. Located in Spokane Valley, WA.

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✓ Kaiser Permanente Humana

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	$977 - $11,418	24%
Blue Cross Blue Shieldmajor	$958 - $10,086	24%
Aetnamajor	$4,124 - $14,313	103%
Cignamajor	$5,481	137%
Kaiser Permanentemajor	$12,595	315%
Ambetter (Centene)	$7,407	185%
Molina	$949 - $7,869	24%
PacificSource	$3,706 - $4,393	93%
WellCare	$4,204	105%
+ 3 smaller / regional plans	$958 - $9,643

Excludes 2 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 5,534), 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 Multicare Valley 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 Multicare Valley Hospital

Compare: Breast lump removal at other WA hospitals

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