Lumpectomy (breast) is a surgical procedure. Prices are from 1555 US hospitals across 52 states, from their machine-readable files.
Price comparison (median)
Typical cash price here is $3,923 — about 5.2× the Medicare rate ($750). High vs Medicare. A fair cash price is usually within ~2× Medicare ($1,500).
💡 Asking for the cash price instead of the $5,534 list price could save about $1,612 (29%).
Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.
Lowest cash prices
| Hospital | Location | Cash | Insurer | CMS rating | ER wait | Readmit |
|---|---|---|---|---|---|---|
| West Penn Hospital | Pittsburgh, PA | $596 | $861 | ★ 3/5 | 208 min | — |
| Bassett Healthcare | Cooperstown, NY | $600 | $613 | ★ 2/5 | 199 min | — |
| King's Daughters Medical Center-Brookhaven | Brookhaven, MS | $689 | $4,857 | ★ 3/5 | 140 min | — |
| Ste Genevieve County Memorial Hospital | Sainte Genevieve, MO | $708 | $708 | ★ 4/5 | 103 min | — |
| Hugh Chatham Memorial Hospital | Elkin, NC | $753 | $847 | ★ 3/5 | 168 min | — |
| Vanderbilt Bedford Hospital | Shelbyville, TN | $767 | $1,190 | ★ 4/5 | 125 min | — |
| Vanderbilt Tullahoma-Harton Hospital | Tullahoma, TN | $767 | $1,190 | ★ 3/5 | 168 min | — |
| Boulder Community Health | Boulder, CO | $775 | $1,256 | ★ 4/5 | 135 min | — |
| Community Hospital, Onaga and St Marys Campus | Onaga, KS | $778 | $1,017 | — | 136 min | — |
| Grove Hill Memorial Hospital | Grove Hill, AL | $784 | $3,614 | — | 166 min | — |
| Avera Marshall Regional Medical Ctr | Marshall, MN | $834 | $1,420 | — | 126 min | — |
| Marshall County Healthcare Center-CAH | Britton, SD | $834 | $1,420 | — | 105 min | — |
| Cameron Memorial Community Hospital Inc | Angola, IN | $840 | $806 | ★ 3/5 | 171 min | — |
| Pratt Regional Medical Center | Pratt, KS | $847 | $1,650 | ★ 4/5 | 100 min | — |
| Margaret Mary Community Hospital Inc | Batesville, IN | $855 | $814 | — | 132 min | — |
| Jackson General Hospital | Ripley, WV | $857 | — | ★ 3/5 | 127 min | — |
| Summersville Regional Medical Center | Summersville, WV | $857 | — | ★ 2/5 | 136 min | — |
| Kau Hospital | Pahala, HI | $861 | — | — | 79 min | — |
| Hospital Pavia Caguas | Caguas, PR | $863 | $309 | — | — | — |
| Braxton County Memorial Hospital, Inc | Gassaway, WV | $870 | — | — | 102 min | — |
| Potomac Valley Hospital | Keyser, WV | $870 | — | ★ 1/5 | 119 min | — |
| Huggins Hospital | Wolfeboro, NH | $871 | — | ★ 4/5 | 169 min | — |
| Mon Health Medical Center | Morgantown, WV | $882 | $888 | ★ 4/5 | 185 min | — |
| Mon Health Marion | Whitehall, WV | $882 | $888 | — | 86 min | — |
| Bronson Methodist Hospital | Kalamazoo, MI | $887 | $3,735 | ★ 4/5 | 235 min | — |
CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated October 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.
What insurers pay for Lumpectomy (breast)
Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $3,923; Medicare pays $750.
| Insurer | Hospitals | Negotiated median |
|---|---|---|
| Medicaid | 169 |
$28 – $1,451 |
| Medicare | 290 |
$52 – $1,992 |
| Tricare / VA | 208 |
$55 – $5,011 |
| Highmark | 98 |
$60 – $6,784 |
| Univera | 12 |
$89 – $962 |
| Health Net | 145 |
$60 – $8,549 |
| Blue Cross Blue Shield | 842 |
$74 – $9,948 |
| Sanford Health Plan | 32 |
$232 – $6,263 |
| Independent Health | 21 |
$270 – $2,406 |
| MVP Health Care | 53 |
$232 – $7,717 |
| Anthem | 398 |
$78 – $10,218 |
| Kaiser Permanente | 155 |
$61 – $9,537 |
| Geisinger | 38 |
$319 – $6,343 |
| AmeriHealth | 135 |
$232 – $7,545 |
| Centene / Ambetter | 560 |
$54 – $6,647 |
| Molina Healthcare | 430 |
$74 – $6,243 |
| Priority Health | 39 |
$232 – $4,452 |
| HealthPartners | 113 |
$139 – $6,243 |
| Workers' Comp / No-Fault | 51 |
$563 – $6,698 |
| Coventry | 64 |
$163 – $6,639 |
| MultiPlan / PHCS network | 273 |
$135 – $8,569 |
| UCare | 42 |
$441 – $6,599 |
| Amerigroup | 117 |
$615 – $4,130 |
| Security Health Plan | 29 |
$319 – $7,312 |
| Medica | 73 |
$464 – $5,081 |
| Harvard Pilgrim | 27 |
$319 – $6,840 |
| UPMC Health Plan | 68 |
$405 – $10,556 |
| Bright Health | 38 |
$1,257 – $5,281 |
| Humana | 673 |
$177 – $9,251 |
| UnitedHealthcare | 1015 |
$375 – $11,732 |
| Aetna | 899 |
$319 – $11,422 |
| SelectHealth | 32 |
$612 – $9,251 |
| Devoted Health | 114 |
$1,053 – $7,004 |
| Healthcare Highways | 33 |
$3,041 – $8,398 |
| EmblemHealth | 58 |
$510 – $30,889 |
| Cigna | 710 |
$665 – $14,857 |
| Oscar Health | 157 |
$1,169 – $12,517 |
| AvMed | 34 |
$427 – $26,390 |
Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.
Where it’s cheapest
| State | Median cash |
|---|---|
| Puerto Rico | $863 |
| Kentucky | $1,133 |
| Vermont | $1,216 |
| North Dakota | $1,276 |
| West Virginia | $1,392 |
| New Hampshire | $1,493 |
Prices by city
Prices by state
Doctors who perform this
Clinicians who reported the most Medicare volume for this service. This reflects Original Medicare activity only and is a volume signal, not a quality ranking.
| Clinician | Specialty | Location | Medicare services |
|---|---|---|---|
| Kerry-Ann Mcdonald, M.D. | Surgical Oncology | Boca Raton, FL | 118 |
| Alexander Swistel, M.D. | General Surgery | New York, NY | 105 |
| Sharla Patterson, MD | General Surgery | Naples, FL | 104 |
| Jerri Fant, MD | Surgical Oncology | North Little Rock, AR | 98 |
| Pamela Wright, M.D. | General Surgery | Bethesda, MD | 97 |
| Stephanie Byrum, MD | General Surgery | Gilbert, AZ | 97 |
| John Droesch, M.D. | General Surgery | Richland, WA | 93 |
| Michele Gadd | Surgical Oncology | Boston, MA | 92 |
| Alexandra Heerdt, MD | General Surgery | New York, NY | 90 |
| Suniti Nimbkar, M.D. | General Surgery | South Weymouth, MA | 88 |
| Rachel Jendro, DO, FACOS | Surgical Oncology | Lincoln, NE | 86 |
| Michelle Specht, MD | Surgical Oncology | Boston, MA | 85 |
Does Medicare cover Lumpectomy (breast)?
Yes — Medicare generally covers Lumpectomy (breast). It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $750. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $150 — unless a Medicare Advantage or supplemental (Medigap) plan covers it.
General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.
About these prices
Based on prices published by 1555 US hospitals across 52 states, the typical (median) cash price is $3,923, versus a chargemaster (list) price around $5,534, a median insurer-negotiated rate of $4,747, a Medicare rate of about $750. Most cash prices fall between $1,051 and $13,846 — a wide spread, which is exactly why comparing hospitals pays off.
How to save
- Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
- Compare several nearby hospitals; prices for the same service can differ severalfold.
- Request a written estimate and the billing code (CPT/DRG) before scheduling.
- Use the Medicare benchmark above to judge whether a quote is reasonable.
- If you are uninsured, ask about financial assistance or prompt-pay discounts.
Frequently asked questions
How much does Lumpectomy (breast) cost without insurance?
Does Medicare cover Lumpectomy (breast)?
What does Medicare pay for Lumpectomy (breast)?
Why do Lumpectomy (breast) prices vary between hospitals?
Is the cash price lower than using insurance?
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