CMS Price Transparency Data
Breast lump removal
Facility: Whittier Hospital Medical Center
Billing Code: 19120 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 19120
- Insurance Median: $4,955
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Whittier Hospital Medical Center is $4,955. 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 1.24x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$4,955
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: $4,955 (124%)
Ins. Median: $4,955 (124% 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
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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 | $211 - $4,955 | 5% |
| Allied Physicians | $211 - $7,554 | 5% |
| Alta Med Health Network | $211 - $4,955 | 5% |
| Altamed Health Services Corporation | $211 | 5% |
| Beverly Hospital | $211 - $5,539 | 5% |
| Brand New Day | $211 - $6,194 | 5% |
| Emanate Health | $211 - $6,189 | 5% |
| Health Net | $211 - $4,955 | 5% |
| Healthy Way La | $211 | 5% |
| Heritage Provider Network | $211 - $6,798 | 5% |
| Kaiser Foundation | $211 - $17,626 | 5% |
| La Care Healthy Families/Healthy Kids | $211 | 5% |
| Non Contracted Medi-Cal | $211 | 5% |
| Prospect Health Plan | $211 - $8,057 | 5% |
| Synermed | $211 - $5,036 | 5% |
| La Care Health Plan | $242 - $4,955 | 6% |
| Caloptima | $295 - $4,955 | 7% |
| Monarch Healthplan | $295 | 7% |
| Care First Health Plan | $302 | 8% |
| County Of Los Angeles Dept Of Health Services | $302 | 8% |
| Medi Caid/ Medi Cal | $302 | 8% |
| Applecare Medical Group | $516 | 13% |
| Central Health Plan Of California | $545 | 14% |
| Aetna | $655 - $7,185 | 16% |
| Universal Care | $670 - $1,100 | 17% |
| Medicare (plans) | $727 - $5,202 | 18% |
| Health Net Inc | $866 - $12,937 | 22% |
| Pacific Independent Physician Association | $1,400 | 35% |
| UnitedHealthcare | $1,530 - $7,997 | 38% |
| Capnet | $2,000 | 50% |
| Edward Medical Group | $2,000 | 50% |
| Molina Medical Center | $2,084 - $6,295 | 52% |
| Alignment Health Plan | $2,385 | 60% |
| Great-West Healthcare Of California | $2,500 | 62% |
| Prohealth | $2,500 | 62% |
| Care 1St Health Plan | $2,600 - $5,500 | 65% |
| Blue Cross Blue Shield | $2,696 - $10,239 | 67% |
| Cost Containment | $2,800 | 70% |
| Veterans Administration | $3,525 | 88% |
| Blue Shield Of California | $3,819 - $5,036 | 95% |
| Avanti | $4,532 - $6,043 | 113% |
| Hollywood Presbyterian Adv Med Mcal | $4,532 | 113% |
| Hollywood Presbyterian Medpoint Mcal | $4,532 | 113% |
| Ahmc Reciprocity | $4,955 - $5,036 | 124% |
| Alta Los Angeles Hospitals Inc | $4,955 | 124% |
| Apa/Aco Inc | $4,955 | 124% |
| Central Health Plan | $4,955 | 124% |
| Easy Choice Health Plan | $4,955 | 124% |
| Humana | $4,955 | 124% |
| Pacificare Of California | $4,955 | 124% |
| Scan Health Plan | $4,955 | 124% |
| Ahmc Medi-Cal Reciprocity Agreement | $5,036 | 126% |
| Ahmc Reciprocity Agreement Senior/Commercial | $5,036 | 126% |
| Caremore | $5,036 | 126% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $5,036 | 126% |
| La Care Covered Direct | $5,036 | 126% |
| Pacific Alliance Medical Center | $5,036 | 126% |
| Private Pay | $5,036 | 126% |
| Self-Pay | $5,036 | 126% |
| Tricare | $5,036 | 126% |
| Molina Healthcare Of California | $5,203 | 130% |
| San Miguel Health Plan | $5,539 | 138% |
| Chinatown Service Center Pace | $6,043 | 151% |
| Ahmc Health | $6,295 | 157% |
| Knox-Keene Act | $6,295 | 157% |
| Fmc Los Angeles County | $6,363 | 159% |
| Interplan Health Group | $6,497 | 162% |
| Athens Administrators Ahmc Work Comp | $6,698 | 167% |
| Misc 1 | $6,698 | 167% |
| Multiplan Wc | $6,698 | 167% |
| Healthnet | $12,549 - $15,113 | 314% |