CMS Price Transparency Data

Breast lump removal

Facility: Bethesda Hospital East

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,089
  • Cash Discount Price: $5,544
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Bethesda Hospital East is $4,089. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,544. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.02x the Medicare baseline. Located in 2815 S Seacrest Blvd, Boynton Beach, FL.
Cash / Self-Pay
$5,544

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,089

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: $5,544 (139%)
Insurance Median: $4,089 (102%)
Cash: $5,544 (139% of Medicare)
Ins. Median: $4,089 (102% 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
Amerigroup $841 - $1,262 21%
Medicaid / KanCare $841 - $1,388 21%
Sunshine State $841 - $1,262 21%
UnitedHealthcare $841 - $8,529 21%
Wellcare $841 - $1,262 21%
Aetna $883 - $4,579 22%
Vista $883 - $1,325 22%
Cigna $1,617 - $4,293 40%
Avmed $3,036 - $4,498 76%
Non Contracted $3,130 78%
Amerihealth $3,838 96%
Blue Cross Blue Shield $4,089 - $8,529 102%
Leon Medical $4,089 102%
Medica Health Plan $4,089 102%
Medicare (plans) $4,089 - $5,520 102%
Humana $4,252 106%
Affordable $5,544 139%
International $5,544 139%
Dimension Health Plan $7,676 192%
Phcs $7,676 192%
Quality Health $7,676 192%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2815 S Seacrest Blvd, Boynton Beach, FL 33435
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals