CMS Price Transparency Data

Breast lump removal

Facility: Wheeling Hospital, Inc

Billing Code: 19120 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$3,811

about 1.0× the $4,000 Medicare rate · typically $1,219–$4,311

modeled estimate · not a bill or quote

What this hospital charges insurers

$3,957

About the fair price

about $146 over the fair price · 1.0× Medicare

Medicare pays $4,000 Fair price $3,811 This hospital $3,957 Cash price $14,149 Hospital's list price $28,298

How we calculate the fair BaseRate →

How this hospital compares to other WV hospitals

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

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 $3,811 (about 1.0× the $4,000 Medicare rate). Wheeling Hospital, Inc charges insurers about $3,957, or about $14,149 in cash — about the fair price. Located in Wheeling, 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✓ Humana CignaKaiser 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	$4,108	103%
Blue Cross Blue Shieldmajor	$3,769 - $15,464	94%
Aetnamajor	$3,957	99%
Humanamajor	$3,957	99%
+ 2 smaller / regional plans	$3,769 - $3,957

Government programs also on file: Medicare, Medicaid.

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 14,149), 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 Wheeling Hospital, Inc 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 Wheeling Hospital, Inc

Compare: Breast lump removal at other WV hospitals

Charleston Area Medical Center · Charleston $551
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

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