CMS Price Transparency Data

Breast lump removal

Facility: Southern Regional Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,908
  • Cash Discount Price: $3,908
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Southern Regional Medical Center is $3,908. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,908. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.98x the Medicare baseline. Located in 11 Upper Riverdale Road, Sw, Riverdale, GA.
Cash / Self-Pay
$3,908

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,908

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: $3,908 (98%)
Insurance Median: $3,908 (98%)
Cash: $3,908 (98% of Medicare)
Ins. Median: $3,908 (98% 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
Humana $1,041 - $3,830 26%
Blue Cross Blue Shield $2,725 - $3,908 68%
Aetna $3,908 - $4,085 98%
Americas Choice Provider Network $3,908 98%
Cigna $3,908 - $8,149 98%
Clear Spring Health Plan $3,908 98%
Corvel $3,908 98%
Georgia Workers’ Compensation $3,908 98%
Medicare (plans) $3,908 98%
Multiplan $3,908 98%
Novanet $3,908 98%
Prime Health Services $3,908 98%
Provider Select $3,908 98%
Riverwood Behavioral Health $3,908 - $4,885 98%
Three Rivers $3,908 98%
Tricare $3,908 98%
UnitedHealthcare $3,908 98%
Caresource $4,025 - $6,839 101%
Devoted Health $4,025 101%
Peach State $4,025 - $4,690 101%
Sonder Health Plan $4,103 103%
Wellcare $4,103 103%
Oscar Health Plan $5,080 127%
Employer Direct Healthcare $5,471 137%
Centurion $5,862 147%
Naphcare $6,057 151%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11 Upper Riverdale Road, Sw, Riverdale, GA 30274
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals