CMS Price Transparency Data

Breast lump removal

Facility: Baptist Health Medical Center - Jacksonville

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $2,797
  • Cash Discount Price: $3,224
  • vs. Medicare Baseline: 0.70x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Baptist Health Medical Center - Jacksonville is $2,797. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,224. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.70x the Medicare baseline. Located in 800 Prudential Dr, Jacksonville, FL.
Cash / Self-Pay
$3,224

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,797

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: $3,224 (81%)
Insurance Median: $2,797 (70%)
Cash: $3,224 (81% of Medicare)
Ins. Median: $2,797 (70% 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
Non-Contracted $711 18%
Amerigroup Of Georgia $860 21%
Caresource Of Georgia $860 - $3,082 21%
Daniel Memorial $860 21%
Humana $860 - $946 21%
Peach State Health Plan $860 - $3,082 21%
Simply Healthcare Plans $903 - $1,031 23%
Simply Healthcare Plans - Cha $903 23%
Amerihealth Caritas $946 24%
Florida Community Care $946 - $4,036 24%
Sunshine State Health Plan $946 24%
United Community Plan $946 24%
Vivida Health $946 24%
Nemours Research $983 25%
Molina Healthcare Of Florida $1,023 26%
Aetna $1,031 - $3,921 26%
UnitedHealthcare $1,138 - $3,882 28%
Blue Cross Blue Shield $1,375 - $64,895 34%
Avmed $1,517 - $2,465 38%
Cigna $1,849 - $2,892 46%
Borland Groover $1,896 47%
Occunet $1,896 - $2,370 47%
Northeast Florida State Hospital $1,991 - $2,228 50%
Centivo $2,086 - $4,030 52%
Capital Health Plan $2,181 55%
Innovative Healthware Services $2,228 56%
Geo Group $2,370 59%
Volusia Health Network $2,608 65%
Watchtower $2,608 65%
Fscj Student Insurance $2,845 71%
Suddath Company $2,987 75%
Medicaid / KanCare $3,082 77%
Uf Health Proton Therapy Institute $3,319 83%
Phcs $3,556 - $3,793 89%
Community Hospice Of Northeast Florida $3,829 - $3,844 96%
Pace $3,829 - $3,844 96%
Tomorrow'S Rainbow $3,829 - $3,844 96%
Va Ccn $3,829 - $3,844 96%
Devoted $4,059 - $4,074 101%
Upmc $4,212 - $4,228 105%
Evolutions Healthcare $4,267 107%
Multiplan $4,267 107%
Corvel $4,646 116%
Coventry Workers Comp $4,646 116%
Ambetter / Centene $9,190 - $9,225 230%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Prudential Dr, Jacksonville, FL 32207
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals