CMS Price Transparency Data

Breast lump removal

Facility: Boone Memorial Hospital

Billing Code: 19120 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$1,026
about 0.3× the $4,000 Medicare rate · typically $685–$2,017
modeled estimate · not a bill or quote
What this hospital charges insurers
$1,593
Above the fair price
about $567 over the fair price · 0.4× Medicare
Medicare pays $4,000 Fair price $1,026 This hospital $1,593 Cash price $2,565 Hospital's list price $5,130

How we calculate the fair BaseRate →

How this hospital compares to other WV hospitals

A typical price — 5 charge more and 3 charge less, among the 9 WV hospitals compared.

Cheapest $551 Priciest $3,957

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

A fair price for a Breast lump removal is about $1,026 (about 0.3× the $4,000 Medicare rate). Boone Memorial Hospital charges insurers about $1,593, or about $2,565 in cash — above the fair price. Located in Madison, WV.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $1,026. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana UnitedHealthcareKaiser 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
Blue Cross Blue Shieldmajor $468 - $2,774 12%
Aetnamajor $334 - $9,412 8%
Cignamajor $263 - $7,391 7%
Humanamajor $352 - $2,718 9%
Government programs also on file: Medicare, Medicaid.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 701 Madison Avenue, Madison, WV 25130
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals