CMS Price Transparency Data

Breast lump removal

Facility: Fairview Park Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $6,387
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Fairview Park Hospital is $6,387. 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 1.60x the Medicare baseline. Located in 200 Industrial Boulevard, Dublin, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,387

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: $6,387 (160%)
Ins. Median: $6,387 (160% 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
Memorial Health Plan $1,758 - $2,297 44%
Health One Alliance $1,776 44%
Americas 1St Choice $2,205 55%
Amerigroup $2,365 59%
Peach State $2,375 59%
Wellcare $2,375 59%
Ambetter / Centene $2,984 75%
Friday Health $4,368 109%
Aetna $4,613 - $6,459 115%
Nhc Advantage $4,950 124%
Pruitt Health $4,950 124%
United $5,400 135%
Blue Cross Blue Shield $6,316 - $7,683 158%
Cigna $7,390 - $9,852 185%
Core Resources $7,411 185%
Centurion $7,512 188%
Prime Health $9,476 237%
Employer'S Health Network $9,674 242%
Rockport United Network $9,674 242%
Identity Mco $9,871 247%
Synergy Health Network $9,871 247%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Industrial Boulevard, Dublin, GA 31021
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals