CMS Price Transparency Data

Breast lump removal

Facility: Lawrence Memorial Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $387
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.10x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Lawrence Memorial Hospital is $387. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.10x the Medicare baseline. Located in 1309 West Main Street, Walnut Ridge, AR.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$387

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%)

Insurance Median: $387 (10%)

Ins. Median: $387 (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
Arkansas Total Care	$108 - $540	3%
Caresource	$112 - $739	3%
Ambetter / Centene	$260 - $674	6%
Amerigroup	$260 - $674	6%
Humana	$260 - $674	6%
Allwell	$273 - $708	7%
Wellcare	$273 - $708	7%
Blue Cross Blue Shield	$276 - $3,496	7%
Qualchoice	$299 - $776	7%
Cigna	$312 - $809	8%
Empower Healthcare Solutions	$336 - $378	8%
Arkansas Superior Select	$395	10%
Provider Partners Health Plans	$395	10%
Wellcare By Allwell	$395	10%
Wellcare Health Plans	$395	10%
Qualchoice Of Arkansas	$433	11%
Covenant Healthcare	$485 - $1,400	12%
Assured Benefits Administrators	$602	15%

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 $X.
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 Lawrence Memorial Hospital 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.