CMS Price Transparency Data

Breast lump removal

Facility: Ochsner Choctaw General

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $407
Cash Discount Price: $914
vs. Medicare Baseline: 0.10x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Ochsner Choctaw General is $407. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $914. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.10x the Medicare baseline. Located in 401 Vanity Fair Lane, Po Box 618, Butler, AL.

Cash / Self-Pay

$914

Average discount available for prompt cash payment at this facility.

Insurance Median

$407

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: $914 (23%)

Insurance Median: $407 (10%)

Cash: $914 (23% of Medicare)

Ins. Median: $407 (10% 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
Humana	$307 - $370	8%
Blue Cross Blue Shield	$312	8%
Medicaid / KanCare	$338 - $355	8%
Cigna	$370 - $593	9%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$370	9%
Medicare (plans)	$370 - $425	9%
UnitedHealthcare	$370 - $1,032	9%
Shared Health Mississippi	$388	10%
Prime Health Services Ppo	$425	11%
Primewell Health Services Commercial Exchange Plan	$703	18%
Primewell Health Services – Commercial	$703	18%
Claritev D/B/A Multiplan/Phcs/American Life Care	$712	18%
Aetna	$776	19%
Select Administrative Services Network	$841	21%
Prime Health Services Ppo -Workers Comp	$1,078	27%
Cor Vel	$1,090	27%
Zelis	$1,540	38%

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 $914.
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 Ochsner Choctaw General 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.