CMS Price Transparency Data

Breast lump removal

Facility: San Gorgonio Memorial Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $5,011
  • Cash Discount Price: $1,318
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at San Gorgonio Memorial Hospital is $5,011. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,318. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.25x the Medicare baseline. Located in 600 North Highland Springs Avenue, Banning, CA.
Cash / Self-Pay
$1,318

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,011

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: $1,318 (33%)
Insurance Median: $5,011 (125%)
Cash: $1,318 (33% of Medicare)
Ins. Median: $5,011 (125% 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 $1,611 - $5,011 40%
Lasalle Medical Associates $4,761 119%
Beaver Medical Group $5,011 125%
Blue Shield $5,011 125%
Choice Physicians Network $5,011 125%
Heritage Provider Network $5,011 125%
Inland Empire Health Plan $5,011 - $5,512 125%
Kaiser $5,011 - $15,034 125%
Providence Health Network $5,011 125%
Redlands Community Hospital $5,011 - $6,013 125%
UnitedHealthcare $5,011 125%
Easy Choice Health Plan $5,262 132%
Epic Management $5,262 132%
Velocity $5,512 138%
Imperial Health Plan $5,663 142%
Health Net $6,404 - $7,176 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 North Highland Springs Avenue, Banning, CA 92220
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals