CMS Price Transparency Data

Breast lump removal

Facility: Medstar Georgetown University Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,764
  • Cash Discount Price: $5,600
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Medstar Georgetown University Hospital is $4,764. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,600. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.19x the Medicare baseline. Located in 3800 Reservoir Rd, Washington, DC.
Cash / Self-Pay
$5,600

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,764

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: $5,600 (140%)
Insurance Median: $4,764 (119%)
Cash: $5,600 (140% of Medicare)
Ins. Median: $4,764 (119% 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
Medstar Family Choice Inc $637 - $2,866 16%
Blue Cross Blue Shield $2,111 53%
Carefirst Blue Choice Inc $2,401 - $2,833 60%
UnitedHealthcare $2,412 - $19,429 60%
Cigna $2,518 - $10,143 63%
Amerigroup $2,866 72%
Amerihealth Caritas District Of Columbia $2,866 72%
Hscsn $2,866 72%
Carefirst Advantage Inc $4,625 116%
Tricare $4,625 116%
Aetna $4,764 - $4,974 119%
Health Care Service Corporation $4,857 121%
Humana $4,857 121%
Pfc $5,600 140%
Private Healthcare Systems (Phcs) $6,892 172%
First Health $7,323 183%
Beech Street $7,754 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3800 Reservoir Rd, Washington, DC 20007
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals