CMS Price Transparency Data
Breast lump removal
Facility: Monterey Park Hospital
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 Monterey Park Hospital 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 900 S Atlantic Blvd, Monterey Park, 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 |
|---|---|---|
| Access Ipa Ancillary | $211 - $441 | 5% |
| Accountable Ipa | $211 | 5% |
| Allied Physicians | $211 - $7,554 | 5% |
| Alta Med Health Services Corp | $211 - $12,500 | 5% |
| Altamed Health Network | $211 - $4,955 | 5% |
| Applecare Medical Group | $211 - $4,029 | 5% |
| Assess Ipa | $211 | 5% |
| Associated Hispanic Physicians Ancillary | $211 - $343 | 5% |
| Beverly Hospital | $211 - $5,539 | 5% |
| Blue Cross Blue Shield | $211 - $9,533 | 5% |
| Brand New Day | $211 - $6,295 | 5% |
| Care 1St Mcl/Gar Cap | $211 | 5% |
| Community Health Plan | $211 | 5% |
| Esperanza Medical Group Ipa | $211 | 5% |
| Family Health Alliance Medical Group | $211 - $1,400 | 5% |
| Health Net Medi Cal | $211 | 5% |
| Healthnet Inc | $211 | 5% |
| Healthy Way La | $211 | 5% |
| La Care | $211 - $5,036 | 5% |
| La Care Health Plan | $211 - $242 | 5% |
| Medical Managed Care Program | $211 | 5% |
| Molina Healthcare | $211 | 5% |
| Other Non-Contracted Medi-Cal | $211 | 5% |
| Preferred Ipa | $211 - $6,295 | 5% |
| Preferred Ipa Of California | $211 | 5% |
| Alhambra Community Dialysis Unit Inc | $272 | 7% |
| Aids Health Foundation | $302 - $4,955 | 8% |
| Bella Vista Medical Group Ancillary | $302 | 8% |
| Central Health Plan | $302 | 8% |
| Emanate Health | $302 - $6,295 | 8% |
| Maxi Med Inc/Ipa | $302 - $5,036 | 8% |
| Medi Cal | $302 | 8% |
| Pacific Independent Physician Association | $302 - $1,400 | 8% |
| Caloptima Direct | $444 | 11% |
| Aetna | $530 - $4,955 | 13% |
| Central Health Plan Of California | $553 | 14% |
| One Health Plan | $610 | 15% |
| Health Net | $866 - $4,955 | 22% |
| Allied Physicians Ipa | $1,100 | 27% |
| Tenet Reciprocity | $1,200 | 30% |
| Universal Care | $1,250 | 31% |
| Blue Shield Of California | $1,273 - $5,036 | 32% |
| Molina Medical Centers | $2,023 | 51% |
| Choice Care Network | $2,090 | 52% |
| Healthnet | $2,155 | 54% |
| Asi Flex Ppo W/C | $2,500 | 62% |
| Veterans Administration | $3,525 | 88% |
| Bella Vista Medical Group | $4,029 | 101% |
| Senior Citizens Choice | $4,462 | 112% |
| Avanti | $4,532 - $6,043 | 113% |
| Hollywood Presbyterian Adv Med Mcal | $4,532 | 113% |
| Hollywood Presbyterian Medpoint Mcal | $4,532 | 113% |
| Ahmc Healthcare Inc | $4,955 - $5,036 | 124% |
| Apa/Aco Inc | $4,955 | 124% |
| Cms | $4,955 | 124% |
| Easy Choice Health Plan | $4,955 | 124% |
| First Health Senior | $4,955 | 124% |
| Foundation Health Plan | $4,955 | 124% |
| Health Net Inc | $4,955 - $17,641 | 124% |
| Humana | $4,955 | 124% |
| Medicare (plans) | $4,955 - $5,203 | 124% |
| Scan Health Plan | $4,955 | 124% |
| Secure Horizons | $4,955 | 124% |
| Ucla/Impact Cancer | $4,955 | 124% |
| UnitedHealthcare | $4,955 | 124% |
| Care 1St M Cal | $5,000 | 125% |
| Garfield Medical Center | $5,000 | 125% |
| Ahmc Reciprocity Agreement Senior/Commercial | $5,036 | 126% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $5,036 | 126% |
| La Care Covered Direct | $5,036 | 126% |
| Self-Pay | $5,036 | 126% |
| Molina Healthcare Medi-Connect | $5,203 | 130% |
| San Miguel Health Plan | $5,539 | 138% |
| Preferred Health Network | $6,101 | 153% |
| Interplan | $6,230 | 156% |
| Ahmc Health Epo | $6,295 | 157% |
| Knox-Keene Act | $6,295 | 157% |
| Molina Healthcare Of California | $6,295 | 157% |
| Athens Administrators | $6,422 | 161% |
| Indemnity W Comp Fee Schedule | $6,422 | 161% |
| Multiplan | $6,422 | 161% |
| Alignment Health Plan | $6,690 | 167% |
| Health Net Of California | $14,997 | 375% |
| Pacificare | $17,009 - $21,350 | 425% |
| Corvel Corporation | $40,000 | 1000% |