CMS Price Transparency Data

Breast lump removal

Facility: University of Colorado Hospital Authority

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $3,734
Cash Discount Price: $2,651
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at University of Colorado Hospital Authority is $3,734. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,651. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.93x the Medicare baseline. Located in 12605 E 16Th Ave, Aurora, CO.

Cash / Self-Pay

$2,651

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,734

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: $2,651 (66%)

Insurance Median: $3,734 (93%)

Cash: $2,651 (66% of Medicare)

Ins. Median: $3,734 (93% 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
UnitedHealthcare	$993 - $6,958	25%
Select Health	$1,229 - $3,848	31%
Blue Cross Blue Shield	$1,827 - $4,454	46%
Rocky Mountain Health Plan	$2,472 - $3,863	62%
Denver Health Medical Plan	$2,802 - $4,014	70%
Simplified Benefits Administration	$2,931 - $3,120	73%
Kaiser Public Option	$2,957	74%
Cigna	$3,037 - $3,935	76%
Aetna	$3,166 - $6,906	79%
Cms	$3,848	96%
Devoted Health	$3,848	96%
Humana	$3,848	96%
Kaiser	$3,848 - $4,447	96%
Phcs	$4,166	104%
Multiplan	$4,544	114%
First Health	$5,302	133%
Midlands Choice	$5,302	133%

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 $2,651.
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 Colorado Hospital Authority 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.