CMS Price Transparency Data

Breast lump removal

Facility: Saint Francis Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $5,011
  • Cash Discount Price: $5,011
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Saint Francis Medical Center is $5,011. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,011. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.25x the Medicare baseline. Located in 3630 East Imperial Highway, Lynwood, CA.
Cash / Self-Pay
$5,011

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: $5,011 (125%)
Insurance Median: $5,011 (125%)
Cash: $5,011 (125% 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
Aids Healthcare Foundation $302 - $5,111 8%
Avanti Hospitals, Llc $302 - $5,011 8%
Health Net Of Ca $302 - $6,515 8%
Heritage Provider Network $302 8%
Kaiser Hospital Foundation $302 - $5,011 8%
La Care Health Plan $302 - $6,013 8%
Molina $302 - $5,011 8%
Traditional Medi-Cal $302 8%
Blue Shield Of Promise $317 - $5,011 8%
Blue Cross Blue Shield $332 8%
Alignment $5,011 125%
Altamed $5,011 125%
Blue Shield Of Ca, Va $5,011 125%
Elite Health Plan $5,011 125%
Medicare (plans) $5,011 125%
Renal Payer Solutions $5,011 125%
Tricare $5,011 125%
UnitedHealthcare $5,011 125%
Welbe Health Pace $5,011 125%
Brand New Day $5,061 - $7,517 127%
Imperial Health Plan Of Ca $5,312 133%
Coventry Healthcare Wc, Inc. $6,403 160%
Multiplan $6,403 160%
Worker Comp $6,602 165%
Aetna $7,517 188%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3630 East Imperial Highway, Lynwood, CA 90262
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals