CMS Price Transparency Data

Breast lump removal

Facility: Riverside University Health System-Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $6,783
  • Cash Discount Price: $9,044
  • vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Riverside University Health System-Medical Center is $6,783. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,044. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.70x the Medicare baseline. Located in 26520 Cactus Avenue, Moreno Valley, CA.
Cash / Self-Pay
$9,044

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,783

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: $9,044 (226%)
Insurance Median: $6,783 (170%)
Cash: $9,044 (226% of Medicare)
Ins. Median: $6,783 (170% 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
Inland Empire Health Plan Mcal Hmo $211 - $9,044 5%
La Care Health Plan $211 - $9,044 5%
Medi-Cal $211 - $9,044 5%
Medical Groups Commercial Contracted $262 - $9,044 7%
Inland Empire Health Plan $4,865 - $9,044 122%
Medicare (plans) $4,865 - $9,044 122%
Molina $4,865 - $9,044 122%
Blue Cross Blue Shield $5,206 - $9,044 130%
Kaiser $6,783 170%
California Department Of Corrections $8,028 - $9,044 201%
Workers Comp $9,044 226%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 26520 Cactus Avenue, Moreno Valley, CA 92555
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals