CMS Price Transparency Data

Breast lump removal

Facility: The Queens Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $4,536
Cash Discount Price: $25,464
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at The Queens Medical Center is $4,536. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,464. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.13x the Medicare baseline. Located in 1301 Punchbowl St, Honolulu, HI.

Cash / Self-Pay

$25,464

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,536

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: $25,464 (637%)

Insurance Median: $4,536 (113%)

Cash: $25,464 (637% of Medicare)

Ins. Median: $4,536 (113% 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.

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
Alohacare	$258 - $4,603	6%
UnitedHealthcare	$1,550 - $4,817	39%
Hawaii Community Health Alliance	$3,435 - $3,632	86%
Hawaii Mainland Administrators	$3,435 - $3,923	86%
Hmsa	$3,553 - $4,723	89%
Hawaii Western Management Group	$3,632	91%
Hawaii Laborers	$4,536	113%
University Health Alliance	$4,597	115%
Kaiser	$4,603 - $12,888	115%
Ohana Care	$4,603	115%
Mdx Hawaii	$4,817	120%
Seven Corners	$8,515	213%

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 $25,464.
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 The Queens Medical Center 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.