CMS Price Transparency Data

Breast lump removal

Facility: Oroville Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $1,569
Cash Discount Price: $897
vs. Medicare Baseline: 0.39x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Oroville Hospital is $1,569. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $897. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.39x the Medicare baseline. Located in 2767 Olive Highway, Oroville, CA.

Cash / Self-Pay

$897

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,569

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: $897 (22%)

Insurance Median: $1,569 (39%)

Cash: $897 (22% of Medicare)

Ins. Median: $1,569 (39% 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
Blue Cross Blue Shield	$323 - $8,975	8%
Butte County	$416 - $2,841	10%
Cigna	$956 - $6,527	24%
Coventry Health Care	$956 - $6,527	24%
Health Net	$956 - $6,527	24%
Multiplan	$956 - $6,527	24%
Interplan	$1,016 - $6,935	25%
Three Rivers Provider Network	$1,016 - $6,935	25%
UnitedHealthcare	$1,016 - $6,935	25%
Beech Street	$1,076 - $7,343	27%
Healthstar	$1,076 - $7,343	27%
Health Payors Organization	$1,135 - $7,751	28%
Blue Shield Of California	$1,159 - $7,914	29%
Blue Shield Value Network	$3,388	85%
Aetna	$3,632	91%
Community Care	$3,632	91%
Nivano Physicians Inc	$3,632	91%
River City Medical Group	$3,995	100%
Partnership Healthplan Of California	$5,992	150%

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 $897.
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 Oroville 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.