CMS Price Transparency Data

Breast lump removal

Facility: Mat-Su Regional Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $24,443
  • Cash Discount Price: $12,222
  • vs. Medicare Baseline: 6.11x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Mat-Su Regional Medical Center is $24,443. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,222. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 6.11x the Medicare baseline. Located in 2500 South Woodworth Loop, Palmer, AK.
Cash / Self-Pay
$12,222

Average discount available for prompt cash payment at this facility.

Insurance Median
$24,443

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4,000.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4,000.24 (100%)
Cash / Self-Pay: $12,222 (306%)
Insurance Median: $24,443 (611%)
Cash: $12,222 (306% of Medicare)
Ins. Median: $24,443 (611% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4,000.24 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 611% of the Medicare baseline (a markup of 511%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Ak Ladies First Breast And Cervical $514 13%
Veterans Eval Services $609 15%
Medicaid / KanCare $4,367 109%
Medicare (plans) $4,579 114%
Node Champva $4,583 115%
Tricare $4,583 115%
Node Non Par Hospice Agree $4,654 116%
Node Triwest $4,654 116%
Node Va $4,654 116%
Node Us Dept Of Labor $5,817 145%
Self Pay $12,222 306%
Ak Dept Of Corrections $22,406 560%
Blue Cross Blue Shield $22,854 - $24,851 571%
Hccmca $24,443 611%
Aetna $26,073 652%
Multiplan Phcs $30,961 774%
Moda Assurance $32,184 805%
Cigna $32,265 807%
Carlie Trans Grp $34,628 866%
UnitedHealthcare $34,628 866%
First Choice Health $36,665 917%
Multiplan Mpi $37,072 927%
Plan Vista Solutions $37,887 947%
Multiplan Wc $38,702 967%
One Health $38,702 967%
First Health Group $39,109 978%
Medical Control Network Solutions $39,109 978%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2500 South Woodworth Loop, Palmer, AK 99645
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals