CMS Price Transparency Data

Breast lump removal

Facility: UF Health Shands Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,089
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at UF Health Shands Hospital is $4,089. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.02x the Medicare baseline. Located in 1600 Sw Archer Rd, Gainesville, FL.
Cash / Self-Pay
Unavailable

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%)
Insurance Median: $4,089 (102%)
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
Beacon Health Strategies $946 24%
Humana $946 - $4,130 24%
Sunshine State Health Plan $946 24%
UnitedHealthcare $946 - $4,252 24%
Aetna $979 - $989 24%
Florida Community Care $989 25%
Amerihealth Caritas Florida $1,032 26%
Community Care Plan $1,032 26%
Molina $1,032 26%
Simply Healthcare $1,070 27%
Blue Cross Blue Shield $3,844 - $7,101 96%
Vha $3,844 96%
Capital Health Plan $4,089 102%
North Central Hospice $4,089 102%
Wellcare $4,089 102%
Careplus $4,211 105%
Positive Healthcare Partners $4,228 106%
Carelon Health $4,338 108%
Ahf Mco Of Fl $4,498 112%
Devoted Health Plan $4,498 112%
Freedom Health- Inc./Optimum Healthcare- Inc. $4,498 112%
Ghilcrest County $4,805 120%
Levy County $4,805 120%
Wellpath $6,150 154%
Ambetter / Centene $6,381 160%
Florida Health Care Plan $6,919 173%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Sw Archer Rd, Gainesville, FL 32610
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals