CMS Price Transparency Data

Breast lump removal

Facility: Adventist Health Hanford

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $467
Cash Discount Price: $342
vs. Medicare Baseline: 0.12x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Adventist Health Hanford is $467. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $342. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.12x the Medicare baseline. Located in 115 Mall Drive, Hanford, CA.

Cash / Self-Pay

$342

Average discount available for prompt cash payment at this facility.

Insurance Median

$467

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: $342 (9%)

Insurance Median: $467 (12%)

Cash: $342 (9% of Medicare)

Ins. Median: $467 (12% 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
Valley Childrens - All Plans	$76	2%
Aetna	$335	8%
Upn Mcal Profee	$360 - $539	9%
Blue Shield Mcr Adv	$405	10%
Fhcn Pace Mcr Adv-All Plans	$405	10%
Prime Health Mcr Adv- All Plans	$405	10%
Sante Ipa Mcal/Mcare Hmo Profee Only	$405	10%
Tricare	$405	10%
UnitedHealthcare	$405 - $547	10%
Central Valley Med Prov Profee Only-All Plans	$425	11%
Ah Employee Health Plan - All Plans	$445	11%
Cigna	$467	12%
Sante Ipa Hmo Profee Only - All Other Plans	$486	12%
Kaiser - All Other Plans	$546	14%
Kaiser Mcr Adv	$546	14%
Western Growers/Pinnacle- All Plans	$562	14%
Blue Shield Epn	$572	14%
Healthnet - All Other Plans	$590	15%
Blue Shield Non-Epn - All Other Plans	$604	15%
Blue Cross Blue Shield	$771	19%
Universal Hc Mcr Adv Profee - All Other Plans	$5,036	126%
Upn Mcr Adv Profee - All Other Plans	$5,036	126%

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 $342.
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 Adventist Health Hanford 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.