CMS Price Transparency Data

Breast lump removal

Facility: Banner - University Medical Center Phoenix

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,081
  • Cash Discount Price: $2,325
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Banner - University Medical Center Phoenix is $4,081. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,325. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.02x the Medicare baseline. Located in 1111 East McDowell Road, Phoenix, AZ.
Cash / Self-Pay
$2,325

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,081

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: $2,325 (58%)
Insurance Median: $4,081 (102%)
Cash: $2,325 (58% of Medicare)
Ins. Median: $4,081 (102% 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.

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
Blue Cross Blue Shield $1,455 - $4,988 36%
Aetna $1,508 - $5,551 38%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $2,020 50%
Plotkin Health $2,020 50%
UnitedHealthcare $2,177 - $5,714 54%
Arizona Physicians Ipa $2,289 - $4,081 57%
Banner University Health Plan $2,289 - $4,081 57%
Health Choice Arizona, Inc. $2,289 - $6,122 57%
Health Net $2,289 - $6,040 57%
Mercy Care $2,289 - $4,081 57%
Quiktrip Corporation $2,424 61%
Cigna $2,949 - $4,081 74%
Arizona Medical Network $3,142 79%
Provider Network Of America $3,366 84%
Banner Health $4,081 102%
Care 1St $4,081 102%
Gila River Health Care Corporation $4,081 102%
Kaiser Foundation Health Plan $4,081 102%
Triwest Healthcare Alliance Corp - Va Ccn $4,081 102%
Upmc Health Plan $4,081 102%
Wellpoint $4,081 102%
Humana $4,204 105%
Carelon $4,285 107%
Devoted Health Services $4,285 107%
Arizona Priority Care $4,489 112%
Gold Kidney Health Plan $4,489 112%
Naphcare $5,510 138%
Oscar Health Plan $6,734 168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 East McDowell Road, Phoenix, AZ 85006
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals