CMS Price Transparency Data

Breast lump removal

Facility: Baptist Medical Center Beaches

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $2,892
  • Cash Discount Price: $2,939
  • vs. Medicare Baseline: 0.72x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Baptist Medical Center Beaches is $2,892. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,939. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.72x the Medicare baseline. Located in 1350 13Th Ave S, Jacksonville Beach, FL.
Cash / Self-Pay
$2,939

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,892

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: $2,939 (73%)
Insurance Median: $2,892 (72%)
Cash: $2,939 (73% of Medicare)
Ins. Median: $2,892 (72% 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 Of Georgia $860 21%
Daniel Memorial $860 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%
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 - $58,200 34%
Avmed $1,517 - $2,418 38%
Borland Groover $1,896 47%
Occunet $1,896 47%
Cigna $1,991 - $2,892 50%
Northeast Florida State Hospital $1,991 50%
Centivo $2,086 - $4,030 52%
Capital Health Plan $2,181 55%
Geo Group $2,370 59%
Watchtower $2,608 65%
Fscj Student Insurance $2,845 71%
Suddath Company $2,987 75%
Caresource Of Georgia $3,082 77%
Medicaid / KanCare $3,082 77%
Peach State Health Plan $3,082 77%
Phcs $3,556 89%
Community Hospice Of Northeast Florida $3,844 96%
Pace $3,844 96%
Tomorrow'S Rainbow $3,844 96%
Va Ccn $3,844 96%
Devoted $4,074 102%
Upmc $4,228 106%
Evolutions Healthcare $4,267 107%
Multiplan $4,267 107%
Corvel $4,646 116%
Coventry Workers Comp $4,646 116%
Ambetter / Centene $9,225 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1350 13Th Ave S, Jacksonville Beach, FL 32250
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals