CMS Price Transparency Data

Breast lump removal

Facility: Boulder Community Health

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $751
  • Cash Discount Price: $417
  • vs. Medicare Baseline: 0.19x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Boulder Community Health is $751. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $417. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.19x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$417

Average discount available for prompt cash payment at this facility.

Insurance Median
$751

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: $417 (10%)
Insurance Median: $751 (19%)
Cash: $417 (10% of Medicare)
Ins. Median: $751 (19% 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
Medicare (plans) $317 - $3,964 8%
Select Health Colorado Public Option $317 - $8,466 8%
Select Health Value Network $317 - $8,967 8%
Aetna $318 - $3,848 8%
Devoted Health $334 - $3,848 8%
Medicaid / KanCare $347 9%
Rocky Mountain Health Maintenance Organization $347 - $3,964 9%
Colorado Access $382 - $1,508 10%
UnitedHealthcare $415 - $3,954 10%
Humana $417 - $3,848 10%
Blue Cross Blue Shield $481 - $14,541 12%
Health Spring $518 - $3,848 13%
Clear Spring $534 - $3,964 13%
Multiplan $576 - $667 14%
Phcs $576 - $667 14%
Rocky Mountain Health Maintenance Organization Private Plan $584 15%
Integrated Health Plans Bch $626 16%
Beech Street Community Medical Associates $644 16%
Cigna $667 - $6,405 17%
Casualty Management Network, Prime Health Services Behavioral Health $709 18%
Mines And Associates $709 18%
Three Rivers Provider Network $709 18%
Zelis (Profee) $709 18%
Casualty Management Network, Prime Health Services Community Medical Associates $751 19%
National Preferred Provider Network $751 19%
Rockport Healthcare Group Community Medical Associates $751 19%
Usa $751 19%
Rockport Healthcare Group Bch $776 19%
Health Payors Organization $792 20%
Kaiser Ppo $798 - $9,059 20%
Kaiser Public Option $798 - $7,381 20%
Health Management Network Bch Community Medical Associates $801 20%
Health Management Network Community Medical Associates $801 20%
National Provider Network $809 20%
Kaiser $9,017 225%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals