CMS Price Transparency Data

Breast lump removal

Facility: HCA Florida Lawnwood Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $10,063
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.52x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at HCA Florida Lawnwood Hospital is $10,063. 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 2.52x the Medicare baseline. Located in 1700 S 23Rd St, Fort Pierce, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,063

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: $10,063 (252%)

Ins. Median: $10,063 (252% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 252% of the Medicare baseline (a markup of 152%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Cigna	$1,671 - $30,357	42%
Freedom Health	$2,350 - $3,950	59%
Optimum	$2,350	59%
Simply Healthcare Plans	$3,792	95%
United	$3,821 - $31,000	96%
Molina	$3,950 - $5,211	99%
Health Sun Health Plan	$4,200	105%
Corvel Corporation	$4,278	107%
Careworks (Rockport)	$4,368	109%
Prime Health	$4,368	109%
Blue Cross Blue Shield	$4,765 - $24,677	119%
Aetna	$5,079 - $16,947	127%
Pinnacol Workers Comp	$5,865	147%
Multiplan	$6,112	153%
Sunshine State Health Plan	$6,625	166%
Rocky Mountain Health Plan	$6,719	168%
Simply Healthcare	$9,488	237%
Avmed	$9,796 - $26,390	245%
Oscar	$10,148	254%
Humana	$27,777	694%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 19120.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Florida Lawnwood Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 19120.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.