CMS Price Transparency Data

Breast lump removal

Facility: Medical West, An Affiliate of UAB Health System

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $801
Cash Discount Price: $700
vs. Medicare Baseline: 0.20x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Medical West, An Affiliate of UAB Health System is $801. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $700. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.20x the Medicare baseline. Located in 995 9Th Avenue Southwest, Bessemer, AL.

Cash / Self-Pay

$700

Average discount available for prompt cash payment at this facility.

Insurance Median

$801

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: $700 (17%)

Insurance Median: $801 (20%)

Cash: $700 (17% of Medicare)

Ins. Median: $801 (20% 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.

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Cigna	$229 - $3,725	6%
Viva	$466 - $4,119	12%
Phcs	$560 - $653	14%
Beech Street	$578 - $653	14%
One Health Plan	$606	15%
Aetna	$653 - $3,581	16%
Geha	$653	16%
Healthchoice	$653	16%
Alamed	$731	18%
Construction Claims Management	$755	19%
Multiplan	$765	19%
Corvel	$771 - $840	19%
Novanet	$779	19%
Humana	$793 - $3,796	20%
UnitedHealthcare	$801 - $3,940	20%
Department Of Labor	$812	20%
Heritage Summit Health	$812	20%
Pnoa	$840	21%
Three Rivers	$840	21%
Blue Cross Blue Shield	$3,546	89%
Cooper Green	$3,581	90%
Jefferson County Sheriff	$3,581	90%
Triwest	$3,581	90%
United Mine Workers	$3,581	90%
Ambetter / Centene	$4,924	123%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $700.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 19120.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Medical West, An Affiliate of UAB Health System is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 19120.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.