CMS Price Transparency Data

Breast lump removal

Facility: Shands Jacksonville

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,637
  • Cash Discount Price: $5,211
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Shands Jacksonville is $4,637. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,211. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.16x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.
Cash / Self-Pay
$5,211

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,637

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: $5,211 (130%)
Insurance Median: $4,637 (116%)
Cash: $5,211 (130% of Medicare)
Ins. Median: $4,637 (116% 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
Aetna $937 - $7,808 23%
Carelon Health $946 24%
Humana $946 - $8,054 24%
Florida Community Care $989 25%
Simply Healthcare $1,022 26%
Amerihealth Caritas Florida $1,032 26%
Community Care Plan $1,032 26%
Molina $1,032 - $4,997 26%
UnitedHealthcare $1,300 - $5,416 32%
Avmed $2,017 - $2,056 50%
Cigna $2,024 51%
Volusia Health Network $3,980 99%
Ameri-Plus Preferred Care $4,089 102%
Blue Cross Blue Shield $4,089 - $6,733 102%
Capital Health Plan $4,089 - $4,738 102%
Northeast Florida State Hospital $4,169 104%
Beacon Health Strategies $4,211 105%
Careplus Health Plan $4,211 105%
Florida Health Care Plan $4,211 - $6,919 105%
Positive Healthcare Partners $4,228 - $4,498 106%
Devoted Health Plan $4,293 - $4,498 107%
North Florida Evaluation & Treatment Center $4,453 111%
Truli For Health $4,493 112%
Wellcare Of Florida $4,784 120%
Florida Complete Care $5,111 128%
Centivo $5,211 130%
Disney Cruise Line $5,685 142%
Health First Health Plan $6,159 - $6,633 154%
Mental Health Associates $6,159 154%
Wellpath $6,342 159%
Ambetter / Centene $6,381 160%
Prime Health Services $6,633 166%
Florida Health Alliance $6,822 171%
Archbold Medical Center $7,107 178%
Genex $7,107 178%
First Health $8,054 201%
Florida Hospital Healthcare System $8,054 201%
Medsave Usa Tpa $8,054 201%
Fringe Benefits Coordinators $8,528 - $9,002 213%
Multiplan $8,528 213%
Novanet $8,528 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 655 W 8Th St, Jacksonville, FL 32209
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals