CMS Price Transparency Data

Breast lump removal

Facility: University of California Davis Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $13,379
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.34x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at University of California Davis Medical Center is $13,379. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 3.34x the Medicare baseline. Located in 2315 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,379

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%)

Insurance Median: $13,379 (334%)

Ins. Median: $13,379 (334% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 334% of the Medicare baseline (a markup of 234%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Dignity/Chw	$422	11%
Adventist	$426	11%
Generic	$426	11%
Healthnet	$426 - $15,549	11%
Blue Shield	$553	14%
Pipe Trades	$553	14%
Sheet Metal Workers Union(Smw)	$553	14%
Ufcw	$553	14%
Blue Cross Blue Shield	$5,082 - $21,570	127%
UnitedHealthcare	$5,275 - $27,186	132%
Blue Shield Senior	$5,336	133%
Healthnet Senior	$5,386	135%
San Joaquin Health Plan Gmc	$5,590	140%
Carpenters H&W	$21,570	539%
Cement Masons Trust Fund	$21,570	539%
Delta	$21,570	539%
Healthcomp	$21,570	539%
Ironworkers	$21,570	539%
Joint Benefit Trust	$21,570	539%
Laborers Health And Welfare	$21,570	539%
Operating Engrs Health Welfare	$21,570	539%
Sierra Pacific Industries	$21,570	539%
Western Growers	$21,570	539%

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 $X.
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 University of California Davis Medical Center 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.