CMS Price Transparency Data
Breast lump removal
Facility: Uc San Diego Health Hillcrest - Hillcrest Med Ctr
Billing Code: 19120 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 19120
- Insurance Median: $4,406
- Cash Discount Price: $12,072
- vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Uc San Diego Health Hillcrest - Hillcrest Med Ctr is $4,406. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,072. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.10x the Medicare baseline. Located in 200 West Arbor Drive, San Diego, CA.
Cash / Self-Pay
$12,072
Average discount available for prompt cash payment at this facility.
Insurance Median
$4,406
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: $12,072 (302%)
Insurance Median: $4,406 (110%)
Cash: $12,072 (302% of Medicare)
Ins. Median: $4,406 (110% 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 |
|---|---|---|
| Aetna | $65 - $18,577 | 2% |
| Alternate Medi-Cal [2001] | $65 - $302 | 2% |
| Blue Cross Blue Shield | $65 - $21,529 | 2% |
| Blue Shield Promise [1017] | $65 - $348 | 2% |
| Brand New Day [1089] | $65 - $302 | 2% |
| Caremore [2028] | $65 - $302 | 2% |
| Community Eldercare [1027] | $65 - $302 | 2% |
| Medi-Cal [1048] | $65 - $302 | 2% |
| Vantage [1092] | $65 - $22,029 | 2% |
| Ximed [2016] | $65 - $302 | 2% |
| Alternate Molina [1240] | $82 - $381 | 2% |
| Molina [1055] | $82 - $4,865 | 2% |
| Community Health Group [1022] | $84 - $390 | 2% |
| Health Net [1039] | $88 - $23,864 | 2% |
| Alameda Alliance For Health [2027] | $302 | 8% |
| Alignment Health Plan [2020] | $302 | 8% |
| California Department Of Public Health [1237] | $302 | 8% |
| California Health & Wellness Medi-Cal [1122] | $302 | 8% |
| Cms - County Medical Services [1025] | $302 - $23,864 | 8% |
| Community Care Ipa [1131] | $302 | 8% |
| Federal Prison [1031] | $302 | 8% |
| Gold Coast Health Plan [2031] | $302 | 8% |
| Health Plan Of San Joaquin [2032] | $302 | 8% |
| Hemet Community Med Grp - Promisecare [1040] | $302 | 8% |
| Imperial Health Holdings [1132] | $302 | 8% |
| Kern Health Systems [2033] | $302 | 8% |
| La Care Health Plan [2025] | $302 | 8% |
| Medicaid / KanCare | $302 | 8% |
| Regal Mg 'Heritage Provider Network' [2019] | $302 | 8% |
| San Diego County [1071] | $302 - $18,357 | 8% |
| Sd Physicians Med Grp [1076] | $302 - $23,864 | 8% |
| State Of California [1082] | $302 | 8% |
| UnitedHealthcare | $302 - $25,700 | 8% |
| Unlisted Mcal Hmo Non-Contract [1049] | $302 | 8% |
| Inland Empire Health Plan Transplant [1126] | $423 | 11% |
| Inland Empire Health Plan [1121] | $423 | 11% |
| Cal Optima [1016] | $438 | 11% |
| Champva [1020] | $563 | 14% |
| Mid County Physicians Med Grp [1054] | $563 | 14% |
| Cigna | $862 - $22,029 | 22% |
| Humana | $862 - $31,207 | 22% |
| Mc Blue Shield Generic Payor [164016] | $862 - $4,406 | 22% |
| Mc Blue Shield Hmo [164015] | $862 - $4,406 | 22% |
| Mc Brand New Day Generic Payor [164031] | $862 - $4,406 | 22% |
| Mc Brand New Day Hmo [164030] | $862 - $4,406 | 22% |
| Mc Healthnet Generic Payor [164010] | $862 - $4,406 | 22% |
| Mc Healthnet Hmo [164004] | $862 - $4,406 | 22% |
| Mc Hnet Blue&Gold Aco [164017] | $862 - $4,406 | 22% |
| Mc Scan Generic Payor [164034] | $862 - $4,406 | 22% |
| Mc Scan Hmo [164035] | $862 - $4,406 | 22% |
| Uc Aff Blue Shield Sr/Sdsm [164037] | $862 - $4,406 | 22% |
| Padres Workers Compensation [2013] | $1,156 - $5,911 | 29% |
| Padres [2014] | $1,156 - $5,911 | 29% |
| Alternate Healthnet [1007] | $2,492 - $17,806 | 62% |
| Multicultural Med Grp [1057] | $2,607 - $13,327 | 65% |
| Ucr Prompt Pay Payor [8240] | $2,816 - $7,453 | 70% |
| Elizabeth Hospice [2018] | $2,873 - $14,686 | 72% |
| Scripps Clinic [1073] | $2,873 - $22,029 | 72% |
| Blue Shield [1014] | $3,047 - $15,574 | 76% |
| Alternate Health Net Bh [2059] | $3,484 - $17,806 | 87% |
| Healthnet Transplants [1114] | $3,484 - $17,806 | 87% |
| Usoc - Us Olympic Committee [1123] | $3,548 - $18,137 | 89% |
| Global Excel [1036] | $3,592 - $18,357 | 90% |
| Sharp Health Plan [1079] | $3,592 - $18,541 | 90% |
| Graybill Med Grp [1037] | $3,627 - $18,541 | 91% |
| Sharp Community Med Grp [1078] | $3,627 - $18,541 | 91% |
| Sharp Rees Stealy [1080] | $3,627 - $18,541 | 91% |
| Olympus Managed Healthcare Inc [1102] | $3,635 - $18,577 | 91% |
| Scripps Health Plan Services [1075] | $4,310 - $22,029 | 108% |
| Alternate Sheriff Custody [1106] | $4,669 - $23,864 | 117% |
| Arch Health Partners [2000] | $4,669 - $23,864 | 117% |
| Axa Assistance [1098] | $4,669 - $23,864 | 117% |
| Cassidy Med Grp [1019] | $4,669 - $23,864 | 117% |
| Cmn - Canadian Medical Network [1024] | $4,669 - $23,864 | 117% |
| Ets - Lifetrac Network [1103] | $4,669 - $23,864 | 117% |
| Health Net Bh (Mhn) [1038] | $4,669 - $23,864 | 117% |
| Health Net Bh (Mhn) [2010] | $4,669 - $23,864 | 117% |
| Interlink Health Services Transplant [1124] | $4,669 - $23,864 | 117% |
| Interlink Health Transplant [2085] | $4,669 - $23,864 | 117% |
| Mgm Resorts [1053] | $4,669 - $23,864 | 117% |
| National Healthcare Solutions Inc [1100] | $4,669 - $23,864 | 117% |
| Quality Health [1069] | $4,669 - $23,864 | 117% |
| San Diego County Sheriff Custody [2012] | $4,669 - $23,864 | 117% |
| Scripps Coastal Med Grp [1074] | $4,669 - $23,864 | 117% |
| Tri-City [1085] | $4,669 - $23,864 | 117% |
| Kaiser [1046] | $4,813 - $24,598 | 120% |
| Alternate Scan Health [2088] | $4,865 | 122% |
| Pace [2044] | $4,865 | 122% |
| San Diego Pace [2046] | $4,865 | 122% |
| Scan Health [1072] | $4,865 | 122% |
| Embassy Sponsored [1101] | $4,884 - $25,700 | 122% |
| Interplan [1045] | $5,028 - $25,700 | 126% |
| Mercy Physicians Med Grp [1052] | $5,028 - $25,700 | 126% |
| Pacific Foundation [1063] | $5,028 - $25,700 | 126% |
| Beech Street [1012] | $5,387 - $27,536 | 135% |
| First Health [1032] | $5,387 - $27,536 | 135% |
| Admar [1001] | $5,531 - $28,270 | 138% |
| Bps - Benefit Plan Services [1015] | $5,531 - $28,270 | 138% |
| Multiplan [1058] | $5,531 - $28,270 | 138% |
| Private Healthcare Systems [1067] | $5,531 - $36,714 | 138% |
| Carnival Cruises [1018] | $5,746 - $29,371 | 144% |
| Alternate Kaiser Rad Onc [2089] | $7,183 - $36,714 | 180% |
| Sharp Healthcare Transplant [1119] | $9,697 - $49,564 | 242% |
| Alternate Blue Shield [2002] | $11,865 | 297% |
| Blue Shield Transplants [1113] | $11,865 | 297% |