CMS Price Transparency Data

Breast lump removal

Facility: Charleston Area Medical Center

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$619

about 0.2× the $4,000 Medicare rate · typically $398–$1,636

modeled estimate · not a bill or quote

What this hospital charges insurers

$551

Below the fair price — a good deal

about $68 under the fair price · 0.1× Medicare

Medicare pays $4,000 Fair price $619 This hospital $551 Cash price $4,880 Hospital's list price $4,880

How we calculate the fair BaseRate →

How this hospital compares to other WV hospitals

Lowest price of the 9 WV hospitals we have prices for — a strong deal.

Cheapest $551 Priciest $3,957

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Breast lump removal is about $619 (about 0.2× the $4,000 Medicare rate). Charleston Area Medical Center charges insurers about $551, or about $4,880 in cash — below the fair price — a good deal. Located in Charleston, WV.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$551 - $7,771	14%
Blue Cross Blue Shieldmajor	$551 - $7,231	14%
Aetnamajor	$322 - $7,771	8%
Cignamajor	$1,812 - $7,375	45%
CareSource	$826 - $7,930	21%
UniCare	$322 - $324	8%
+ 7 smaller / regional plans	$322 - $7,771

Government programs also on file: Military & VA.

Excludes 4 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 4,880), 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 Charleston Area 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 Charleston Area Medical Center

Compare: Breast lump removal at other WV hospitals

Cabell Huntington Hospital, Inc · Huntington $595
St Marys Medical Center · Huntington $608
Boone Memorial Hospital · Madison $1,593
Weirton Medical Center, Inc · Weirton $1,978
Reynolds Memorial Hospital, Inc · Glen Dale $3,887
Camden Clark Medical Center · Parkersburg $3,924
Berkeley Medical Center · Martinsburg $3,957
Wheeling Hospital, Inc · Wheeling $3,957

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