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Breast lumpectomy in Pennsylvania: what insurers pay

Posted commercial rates at 60 Pennsylvania hospitals, each next to its own Medicare base rate.

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CPT 19301

HospitalMedian across insurers× MedicareInsurersFile date
Upmc Northwest Seneca$2,2970.6×22026-03-06
Upmc St Margaret Pittsburgh$3,0590.8×12026-03-06
St Mary Medical Center Langhorne$3,2200.8×202026-03-31
Upmc Cole Coudersport$3,2540.8×12026-03-06
Magee Womens Hospital Of Upmc Health System Pittsburgh$3,3640.9×22026-03-06
Upmc East Monroeville$3,3940.9×22026-03-06
Conemaugh Memorial Medical Center Johnstown$3,4280.9×12026-04-15
Nazareth Hospital Philadelphia$3,5150.9×192026-03-31
Temple Health - Chestnut Hill Hospital Philadelphia$3,7580.9×62026-04-08
Jefferson Lansdale Hospital Lansdale$4,0961.1×52026-09-15
Holy Redeemer Hospital And Medical Center Meadowbrook$4,1781.1×52026-09-21
Upmc Altoona Altoona$4,2011.1×12026-03-06
Wayne Memorial Hospital Honesdale$4,2051.1×12026-09-16
Jefferson Abington Hospital Abington$4,5801.2×52026-09-15
Upmc Hamot Erie$4,7811.3×32026-03-06
Riddle Memorial Hospital Media$4,7881.2×22026-04-01
Jefferson Hospital Jefferson Hills$4,9101.3×72026-04-14
Paoli Hospital Paoli$5,0001.3×22026-04-01
Bryn Mawr Hospital Bryn Mawr$5,0611.3×22026-04-01
Lankenau Medical Center Wynnewood$5,1191.3×22026-04-01
Hospital Of The Fox Chase Cancer Center Philadelphia$5,3631.3×62026-04-08
Upmc Presbyterian Shadyside Pittsburgh$5,3801.4×12026-03-06
Temple University Hospital Philadelphia$5,4131.4×92026-04-13
Jefferson Einstein Montgomery Hospital East Norriton$5,8001.5×62026-09-15
Upmc Memorial York$5,8751.5×52026-03-06
Jefferson Health-Northeast Philadelphia$5,8801.5×62026-09-15
Upmc Carlisle Carlisle$6,4131.6×32026-03-06
Upmc Lititz Lititz$6,4131.7×32026-03-06
Upmc Hanover Hanover$6,4131.7×32026-03-06
Wellspan York Hospital York$6,4201.7×32026-01-01
Upmc Washington Washington$6,5261.7×42026-03-06
St Luke'S Hospital Bethlehem Bethlehem$6,6821.7×32026-02-26
St Luke'S Hospital - Monroe Campus Stroudsburg$6,6821.8×32026-02-27
St Luke'S Hospital - Carbon Campus Lehighton$6,6821.7×32026-02-27
Saint Vincent Hospital Erie$6,8261.8×62026-04-14
Wellspan Evangelical Community Hospital Lewisburg$7,7512.0×62026-01-01
Allegheny Valley Hospital Natrona$7,7762.0×62026-04-14
Canonsburg General Hospital Canonsburg$7,7962.0×62026-04-14
Grove City Hospital Grove City$7,8362.0×52026-04-14
Forbes Hospital Monroeville$8,0122.1×62026-04-14
Ahn Wexford Hospital Wexford$8,3862.2×62026-04-14
St Luke'S Miners Memorial Hospital Coaldale$8,4232.2×22026-02-27
St Clair Hospital Pittsburgh$8,7512.3×72026-03-31
Geisinger St. Luke'S Hospital Orwigsburg$8,8562.3×22026-02-26
St Luke'S Hospital - Upper Bucks Campus Quakertown$8,9742.4×22026-02-26
Thomas Jefferson University Hospital Philadelphia$9,3042.3×42026-09-15
Allegheny General Hospital Pittsburgh$9,6382.5×62026-04-14
West Penn Hospital Pittsburgh$9,6842.5×62026-04-14
Lehigh Valley Hospital Allentown$10,5822.7×82026-07-01
Wellspan Ephrata Community Hospital Ephrata$11,3023.0×22026-01-01
St Luke'S Hospital - Easton Campus Easton$12,0103.0×22026-02-26
Penn State Health Hampden Medical Center Enola$13,0843.3×12026-03-27
Penn State Health Holy Spirit Medical Center Camp Hill$13,2283.4×12026-03-27
Penn State Health Lancaster Medical Center Lancaster$13,4333.5×12026-03-27
Lehigh Valley Hospital - Dickson City Dickson City$13,8443.6×82026-07-01
Lehigh Valley Hospital - Pocono East Stroudsburg$15,7064.1×82026-07-01
Lehigh Valley Hospital - Hazleton Hazleton$15,8134.2×82026-07-01
Penn State Health St. Joseph Reading$17,3154.3×12026-03-27
Lehigh Valley Hospital - Macungie Macungie$18,0124.5×82026-07-01
Wellspan Chambersburg Hospital Chambersburg$26,4596.7×22026-01-01

CPT 19302

HospitalMedian across insurers× MedicareInsurersFile date
Upmc Cole Coudersport$4,4690.7×12026-03-06
St Mary Medical Center Langhorne$4,8290.8×202026-03-31
Wellspan York Hospital York$6,4201.0×32026-01-01
Holy Redeemer Hospital And Medical Center Meadowbrook$7,0911.1×52026-09-21
Jefferson Hospital Jefferson Hills$8,3621.3×72026-04-14
Riddle Memorial Hospital Media$8,4001.2×22026-04-01
Upmc Altoona Altoona$8,5341.3×12026-03-06
Jefferson Lansdale Hospital Lansdale$8,7041.4×52026-09-15
Jefferson Abington Hospital Abington$8,7041.4×52026-09-15
Paoli Hospital Paoli$8,7181.4×22026-04-01
Bryn Mawr Hospital Bryn Mawr$8,8101.3×22026-04-01
Lankenau Medical Center Wynnewood$8,8961.4×22026-04-01
Temple University Hospital Philadelphia$9,1281.3×92026-04-13
Upmc Hamot Erie$9,7141.5×32026-03-06
Hospital Of The Fox Chase Cancer Center Philadelphia$10,2331.5×62026-04-08
Upmc Memorial York$10,5191.6×52026-03-06
Jefferson Health-Northeast Philadelphia$11,3701.7×62026-09-15
Jefferson Einstein Montgomery Hospital East Norriton$11,3701.8×62026-09-15
Saint Vincent Hospital Erie$11,6251.8×62026-04-14
St Luke'S Hospital - Monroe Campus Stroudsburg$13,2292.0×32026-02-27
Allegheny Valley Hospital Natrona$13,2442.0×62026-04-14
Canonsburg General Hospital Canonsburg$13,2772.0×62026-04-14
Grove City Hospital Grove City$13,3442.1×52026-04-14
Forbes Hospital Monroeville$13,6442.1×62026-04-14
Thomas Jefferson University Hospital Philadelphia$13,7602.0×42026-09-15
Ahn Wexford Hospital Wexford$14,2812.2×62026-04-14
St Luke'S Hospital - Upper Bucks Campus Quakertown$14,8382.3×22026-02-26
St Clair Hospital Pittsburgh$14,8412.3×72026-03-31
Allegheny General Hospital Pittsburgh$16,4142.5×62026-04-14
West Penn Hospital Pittsburgh$16,4912.5×62026-04-14
Lehigh Valley Hospital Allentown$18,1842.7×62026-07-01
Penn State Health Hampden Medical Center Enola$22,1903.3×12026-03-27
Penn State Health Holy Spirit Medical Center Camp Hill$22,4343.4×12026-03-27
Penn State Health Lancaster Medical Center Lancaster$22,7813.5×12026-03-27
Lehigh Valley Hospital - Dickson City Dickson City$23,4783.6×82026-07-01
Wellspan Chambersburg Hospital Chambersburg$26,4594.0×22026-01-01
Lehigh Valley Hospital - Pocono East Stroudsburg$26,6344.1×82026-07-01
Lehigh Valley Hospital - Hazleton Hazleton$26,8174.2×82026-07-01
Penn State Health St. Joseph Reading$29,3654.3×12026-03-27
Lehigh Valley Hospital - Macungie Macungie$30,5454.5×82026-07-01

Questions

How much do insurers pay for breast lumpectomy in Pennsylvania?

60 Pennsylvania hospitals post usable commercial rates for breast lumpectomy in their federal price-transparency files. For CPT 19301, hospital outpatient, the median across 60 hospitals is $6,473, 1.7× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.