CMS Price Transparency Data

Breast lump removal

Facility: Mercyone Waterloo Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $279
  • Cash Discount Price: $7,218
  • vs. Medicare Baseline: 0.07x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Mercyone Waterloo Medical Center is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,218. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.07x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.
Cash / Self-Pay
$7,218

Average discount available for prompt cash payment at this facility.

Insurance Median
$279

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: $7,218 (180%)
Insurance Median: $279 (7%)
Cash: $7,218 (180% of Medicare)
Ins. Median: $279 (7% 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

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $130 - $3,803 3%
Albany County Correctional Facility $136 - $204 3%
Ambetter / Centene $136 - $6,324 3%
Amish Mennonite $136 - $204 3%
Ascension St. Vincent Public Safety Medical $136 - $204 3%
Bcccp-Michigan $136 - $204 3%
Bccp $136 - $204 3%
Blue Cross Blue Shield $136 - $4,000 3%
Bmc Healthnet $136 - $204 3%
Breast Grant-Connecticut $136 - $204 3%
Broward County Dept Of Health $136 - $204 3%
California Health And Wellness $136 - $204 3%
Can Community Health Inc $136 - $204 3%
Cardinal Innovations Lme $136 - $204 3%
Care Connections Of Northern Iowa $136 - $204 3%
Care Oregon Ohp $136 - $204 3%
Cencal Health Plan $136 - $204 3%
Cenpatico $136 - $204 3%
Chhuny $136 - $204 3%
Childrens Comm Health Plan $136 - $204 3%
Childrens Medical Services Title 19 $136 - $204 3%
Cigna $136 - $9,461 3%
City Of Philadelphia $136 - $204 3%
Cmh Allegan County $136 - $204 3%
Cmh Ausable Valley $136 - $204 3%
Cmh Barry County $136 - $204 3%
Cmh Bay-Arenac County $136 - $204 3%
Cmh Berrien County $136 - $204 3%
Cmh Cass County $136 - $204 3%
Cmh Central Mi County $136 - $204 3%
Cmh Clinton-Eaton-Ingham County $136 - $204 3%
Cmh Detroit Wayne Integrated Health Network $136 - $204 3%
Cmh Genesee County $136 - $204 3%
Cmh Ionia County $136 - $204 3%
Cmh Jackson County/Lifeways $136 - $204 3%
Cmh Kalamazoo $136 - $204 3%
Cmh Kent County $136 - $204 3%
Cmh Lenawee County $136 - $204 3%
Cmh Livingston County $136 - $204 3%
Cmh Macomb $136 - $204 3%
Cmh Misc $136 - $204 3%
Cmh Monroe County $136 - $204 3%
Cmh Montcalm County $136 - $204 3%
Cmh Muskegon County $136 - $204 3%
Cmh Newaygo County $136 - $204 3%
Cmh North Country $136 - $204 3%
Cmh Northern Lakes County $136 - $204 3%
Cmh Oakland County $136 - $204 3%
Cmh Ottawa County $136 - $204 3%
Cmh Van Buren County $136 - $204 3%
Cmh Washtenaw County $136 - $204 3%
Cmh Wayne County/Carelink $136 - $204 3%
Cmh Wayne Cty/Com Liv Svcs $136 - $204 3%
Cmh West Mi County $136 - $204 3%
Community Benefit Health $136 - $204 3%
Community Care Behavorial Health $136 - $204 3%
Community Care Partners $136 - $204 3%
Community Health Choice $136 - $204 3%
Connections Csp $136 - $204 3%
County Coroner $136 - $204 3%
County Funding Generic $136 - $204 3%
Covid19 Hrsa Uninsured Testing And Treatment Fund $136 - $204 3%
Dean Wi Badgercare $136 - $204 3%
Delaware County Department Of Health $136 - $204 3%
Delaware First Health $136 - $204 3%
Delta Dental Nj $136 - $204 3%
Dph Tb Program $136 - $204 3%
Dscc $136 - $204 3%
Eastpointe Lme $136 - $204 3%
Family Health Network $136 - $204 3%
Freedom First Healthcare $136 - $204 3%
Fresno County Ccs $136 - $204 3%
Ghc Scw Wi Badgercare $136 - $204 3%
Harbor Health $136 - $204 3%
Health Safety Net $136 - $204 3%
Healthy Blue Ne $136 - $204 3%
Hennepin Health $136 - $204 3%
Humana $136 - $437 3%
Id County Ada $136 - $204 3%
Id County Canyon $136 - $204 3%
Id County Cat Fund $136 - $204 3%
Id County Other $136 - $204 3%
Id County Payette $136 - $204 3%
Idaho Dept Health And Wellfare $136 - $204 3%
Idaho Womens Health Check $136 - $204 3%
Indiana Breast Cervical Cancer $136 - $204 3%
Inland Empire Health Plan $136 - $204 3%
Intercommunity Health Ohp $136 - $204 3%
Jai Medical System $136 - $204 3%
Kern Family Health Plan $136 - $204 3%
Keystone First $136 - $204 3%
Keystone First Chip $136 - $204 3%
La Care Health Plan $136 - $204 3%
Lakeland Care Inc $136 - $204 3%
Managed Health Services - Indiana $136 - $204 3%
Maryland Breast & Cervical Program $136 - $204 3%
Maryland Healthy Smiles - Scion Dental $136 - $204 3%
Maryland Physicians Care $136 - $204 3%
Massachusetts Behavioral Health Partnership $136 - $204 3%
Mdwise $136 - $204 3%
Medi-Cal $136 - $204 3%
Medi-Cal Healthnet $136 - $204 3%
Medstar Dc Healthy Family $136 - $204 3%
Medstar Md Health Choice $136 - $204 3%
Mo Home State Health Plan $136 - $204 3%
Molina Centennial Care $136 - $204 3%
Nascentia Health Options $136 - $204 3%
New York Cancer Services Program $136 - $204 3%
Nextlevel Health $136 - $204 3%
Oregon Screenwise $136 - $204 3%
Pace Of Southwest Michigan $136 - $268 3%
Paramount Advantage $136 - $204 3%
Parkland Community Health Plan $136 - $204 3%
Partners Behavioral Lme $136 - $204 3%
Peach State Healthplan $136 - $204 3%
Philadelphia County Funding $136 - $204 3%
Presbyterian Centennial Care $136 - $204 3%
Prestige Health Choice $136 - $204 3%
Priority Partners $136 - $204 3%
Robert F Sing Program $136 - $204 3%
Rx 340B Pass Along $136 - $204 3%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $136 - $204 3%
Rx Medi-Cal $136 - $204 3%
Rx Meridian Rx $136 - $204 3%
Ryan White Florida Mssrp $136 - $204 3%
Sandhills Center Lme $136 - $204 3%
Screening For Life $136 - $204 3%
St Joseph County Hlth Dpt $136 - $204 3%
Sunshine State Health Plan $136 - $204 3%
Superior Health $136 - $204 3%
Tenncare $136 - $204 3%
Texas Children'S Health Plan $136 - $204 3%
Trillium Community Ohp $136 - $204 3%
Tufts Health Public Plans $136 - $204 3%
UnitedHealthcare $136 - $13,325 3%
Vaya Health Lme $136 - $204 3%
Washtenaw Health Plan $136 - $204 3%
Wellsense Health Plan $136 - $204 3%
Wi Womens Wellness $136 - $204 3%
Iowa Total Care $139 - $3,751 3%
Wellpoint $140 - $210 3%
Aetna $146 - $4,605 4%
Nebraska Total Care $158 4%
Wc Corvel $173 - $260 4%
Align Senior Care $179 - $268 4%
Ally Align Care Adv $179 - $268 4%
American Health Advantage Of Idaho $179 - $268 4%
Aurora Special Needs $179 - $268 4%
Blue Care Network Advantage $179 - $268 4%
Blue Shield - De (Highmark) Medciare Advantage $179 - $268 4%
Care Dimensions $179 - $268 4%
Care Improvement Plus $179 - $268 4%
Care Resources Pace $179 - $268 4%
Careplus Health Plans $179 - $268 4%
Cca - Zing Health $179 - $268 4%
Cca Senior Care Options $179 - $268 4%
Central Valley Medical Services Corp Pace $179 - $268 4%
Champion Health Plan Mcr Advantage $179 - $268 4%
Clear Spring Health $179 - $268 4%
Clover Health $179 - $268 4%
Commonwealth Care Alliance $179 - $268 4%
Community Pace At Home $179 - $268 4%
Eddy Senior Care-Pace $179 - $268 4%
Eddy Seniorcare Pace $179 - $268 4%
Elementcare $179 - $268 4%
Evercare $179 - $268 4%
Everence $179 - $268 4%
Gateway Health Plan $179 - $268 4%
Genesys Pace Of Genesee County $179 - $268 4%
Georgia Health Advantage $179 - $268 4%
Gold Advantage $179 - $268 4%
Gpa Croell Redi Mix $179 - $268 4%
Health America Advantra $179 - $268 4%
Highmark Health Options Dual Plan $179 - $268 4%
Hope Select Pace $179 - $268 4%
Horizon Nj Total Care $179 - $268 4%
Hudson Headwaters Pace $179 - $268 4%
Huron Valley Pace $179 - $268 4%
Innovative Integrated Health Community Plans $179 - $268 4%
Johns Hopkins Advantage Md $179 - $268 4%
Lasso Healthcare Msa $179 - $268 4%
Life St Marys Pace $179 - $268 4%
Lifecircles Pace $179 - $268 4%
Longevity Health Plan $179 - $268 4%
Longevity Ipa Of Michigan Llc Health Plan Isnp $179 - $268 4%
Martins Point Generations Advantage $179 - $268 4%
Mass General Brigham Mcr Adv $179 - $268 4%
Medicare (plans) $179 - $3,839 4%
Medipak Advantage $179 - $268 4%
Mercy Life $179 - $268 4%
Mercyone Cedar Valley $179 - $268 4%
Meridian Complete $179 - $268 4%
Michigan Complete Health $179 - $268 4%
Nascentia Health Plus $179 - $268 4%
New Centry Health Careplus $179 - $268 4%
Osu Prime Care Advantage $179 - $268 4%
Pace Cny $179 - $268 4%
Pace Iowa Immanuel Pathways $179 - $268 4%
Pace Southeast $179 - $268 4%
Pace-Trinity Health $179 - $268 4%
Peak Pace Solutions $179 - $268 4%
Perennial Advantage $179 - $268 4%
Preferred Care Partners $179 - $268 4%
Presbyterian Senior Plan $179 - $268 4%
Provider Partners Health Plan Of Illinois $179 - $268 4%
Provider Partners Health Plan Of Indiana $179 - $268 4%
Pruitthealth Premier $179 - $268 4%
Reliance Community Care Partners Care Resources Pace $179 - $268 4%
Rx Allwin $179 - $268 4%
Rx Grane Grnmedd $179 - $268 4%
Rx Retiree Rx Care $179 - $268 4%
Scan Health Plan Mcr Ipa Meritage Oon $179 - $268 4%
Secure Horizons Ma Pffs $179 - $268 4%
Serenity Pace $179 - $268 4%
Siouxland Pace $179 - $268 4%
Solis Health Plans $179 - $268 4%
Sunnyview-Pace Finance Dept $179 - $268 4%
Texan Plus $179 - $268 4%
The Health Plan $179 - $268 4%
Thome Pace $179 - $268 4%
Todays Options $179 - $268 4%
Tribute Health Plans $179 - $268 4%
Um Health Advantage $179 - $268 4%
Union Health Service $179 - $268 4%
Welbe Health $179 - $268 4%
Wellmed $179 - $268 4%
Veterans Administration $182 - $273 5%
Champva $186 - $279 5%
Iowa Dept Of Public Health $186 - $372 5%
Tricare $186 - $279 5%
Triwest Health Alliance $186 - $279 5%
Us Family Health Plan $186 - $279 5%
Veterans Eval Services $186 - $279 5%
American Health Plan $188 - $281 5%
Iowa Health Advantage $188 - $281 5%
Amish Hospital Aid $242 - $5,006 6%
Amps $246 - $369 6%
Multiplan $275 - $550 7%
Avera $282 - $423 7%
Medical Associates $304 - $3,131 8%
Stephenson Cty Health $319 - $479 8%
Sanford Health Plan $326 - $489 8%
Lucent Health $328 - $4,605 8%
Ucare $331 - $497 8%
Health Smart $337 - $506 8%
Oscar $341 - $5,777 9%
Usa Managed Care $354 - $530 9%
Centivo $365 - $6,248 9%
Health Partners $372 - $8,741 9%
Bcn Domestic $378 - $4,000 9%
Blue Benefit Administrators Of Massachusetts $378 - $4,000 9%
Blue Care Network $378 - $4,000 9%
Blue Distinction Transplant $378 - $4,000 9%
Blue Shield - Ca $378 - $4,000 9%
Blue Shield - Id (Regence) $378 - $4,000 9%
Blue Shield - Ny Highmark Northeastern $378 - $4,000 9%
Blue Shield - Ny Highmark Western $378 - $4,000 9%
Blue Shield - Pa (Highmark) $378 - $4,000 9%
Blue Shield - Wa (Regence) $378 - $4,000 9%
Health Choices $378 - $3,131 9%
Kaiser Domestic $378 - $4,000 9%
Pre-Employment $378 - $4,000 9%
Wc Domestic $378 - $4,000 9%
Claimdoc $381 - $7,566 10%
The Alliance $383 - $574 10%
Global Excel $412 - $618 10%
Preferred One $417 - $625 10%
Velocity $428 - $642 11%
Geha $470 - $705 12%
Quiktrip $503 - $754 13%
Allied Benefit Systems $563 - $4,605 14%
Auxiant $563 - $9,461 14%
First Choice Health $563 - $845 14%
Group Administrators $563 - $845 14%
Midlands $563 - $9,461 14%
Midlands Choice $563 - $9,461 14%
Meritain $609 - $4,605 15%
Newton Correctional Facility $879 - $1,758 22%
Genex Wc $1,014 - $2,028 25%
Wc Align Network $1,082 - $2,163 27%
Wc Praxis Health Network $1,149 - $2,298 29%
Wc Reny Company $1,176 - $2,352 29%
Wc Velocity $1,176 - $2,352 29%
Auto Velocity $1,217 - $2,434 30%
Wc O'Hara Corp $1,217 - $2,434 30%
Andrie Inc $1,352 - $2,704 34%
East Greenbush Central School District $1,352 - $2,704 34%
Healthsmart Workers Comp $1,352 - $2,704 34%
Jag Source $1,352 - $2,704 34%
New York State Insurance Fund $1,352 - $2,704 34%
Njm Insurance Group $1,352 - $2,704 34%
Rx Heatlhcomp $1,352 - $2,704 34%
Rx Restat $1,352 - $2,704 34%
Rx Saif Opdp Wc $1,352 - $2,704 34%
Rx Worker'S Comp $1,352 - $2,704 34%
Wc Accident Fund $1,352 - $2,704 34%
Wc Ace $1,352 - $2,704 34%
Wc Acs Federal Employees $1,352 - $2,704 34%
Wc Acuity $1,352 - $2,704 34%
Wc Advantage $1,352 - $2,704 34%
Wc Aegis $1,352 - $2,704 34%
Wc Aig $1,352 - $2,704 34%
Wc Aims $1,352 - $2,704 34%
Wc Alaska National Ins $1,352 - $2,704 34%
Wc Allied $1,352 - $2,704 34%
Wc Am Trust N America $1,352 - $2,704 34%
Wc American Claims Mgmt $1,352 - $2,704 34%
Wc Amerisure $1,352 - $2,704 34%
Wc Amtrust $1,352 - $2,704 34%
Wc Asu Risk Mgt $1,352 - $2,704 34%
Wc Benetech $1,352 - $2,704 34%
Wc Berkley Admin $1,352 - $2,704 34%
Wc Broadspire $1,352 - $2,704 34%
Wc Broward County $1,352 - $2,704 34%
Wc Bunch & Associates $1,352 - $2,704 34%
Wc California State Comp Ins $1,352 - $2,704 34%
Wc California State Ins Fund $1,352 - $2,704 34%
Wc Capitol Area Health Consortium $1,352 - $2,704 34%
Wc Ccmsi $1,352 - $2,704 34%
Wc Chartis $1,352 - $2,704 34%
Wc Chubb $1,352 - $2,704 34%
Wc Cirma $1,352 - $2,704 34%
Wc City Of Albany $1,352 - $2,704 34%
Wc City Of Sioux City $1,352 - $2,704 34%
Wc Claims Mgmt Inc $1,352 - $2,704 34%
Wc Cna $1,352 - $2,704 34%
Wc Comp One Admin C/O Manageability $1,352 - $2,704 34%
Wc Compone Admin $1,352 - $2,704 34%
Wc Ct Healthcare Trust $1,352 - $2,704 34%
Wc Donegal Insurance Group $1,352 - $2,704 34%
Wc Emc Insurance Company $1,352 - $2,704 34%
Wc Employee Mutual $1,352 - $2,704 34%
Wc Enablecomp $1,352 - $2,704 34%
Wc Encore Health Network $1,352 - $2,704 34%
Wc Erie $1,352 - $2,704 34%
Wc Esis $1,352 - $2,704 34%
Wc Evolutions $1,352 - $2,704 34%
Wc Fcci $1,352 - $2,704 34%
Wc Fed Ex $1,352 - $2,704 34%
Wc Federal Black Lung $1,352 - $2,704 34%
Wc Federated $1,352 - $2,704 34%
Wc Finley Occupational Health $1,352 - $2,704 34%
Wc First Agency/Occunet $1,352 - $2,704 34%
Wc Ford Motor $1,352 - $2,704 34%
Wc Fresno Unified Emp $1,352 - $2,704 34%
Wc Gallagher Bassett $1,352 - $2,704 34%
Wc General Motors $1,352 - $2,704 34%
Wc Generic $1,352 - $2,704 34%
Wc Genex Care For Ohio $1,352 - $2,704 34%
Wc Great West Casualty $1,352 - $2,704 34%
Wc Guarantee Insurance $1,352 - $2,704 34%
Wc Guard Insurance Company $1,352 - $2,704 34%
Wc Hab $1,352 - $2,704 34%
Wc Hartford $1,352 - $2,704 34%
Wc Hastings $1,352 - $2,704 34%
Wc Health Management $1,352 - $2,704 34%
Wc Heritage Summit $1,352 - $2,704 34%
Wc Hireright $1,352 - $2,704 34%
Wc Horizon $1,352 - $2,704 34%
Wc Icw Group $1,352 - $2,704 34%
Wc Idaho State Ins Fund $1,352 - $2,704 34%
Wc Intercare Insurance $1,352 - $2,704 34%
Wc Intermountain $1,352 - $2,704 34%
Wc Johns Eastern $1,352 - $2,704 34%
Wc Kemberton $1,352 - $2,704 34%
Wc Key Ins & Benefit Solutions $1,352 - $2,704 34%
Wc Liberty Mutual $1,352 - $2,704 34%
Wc Mac Risk Management $1,352 - $2,704 34%
Wc Massachusetts $1,352 - $2,704 34%
Wc Mdia $1,352 - $2,704 34%
Wc Meadowbrook Claim $1,352 - $2,704 34%
Wc Medical Administrators $1,352 - $2,704 34%
Wc Meijers $1,352 - $2,704 34%
Wc Memic $1,352 - $2,704 34%
Wc Mercy Workcare $1,352 - $2,704 34%
Wc Michigan $1,352 - $2,704 34%
Wc Michigan Millers Mutual $1,352 - $2,704 34%
Wc Mitchell Frankenmuth $1,352 - $2,704 34%
Wc Mra $1,352 - $2,704 34%
Wc Nationwide $1,352 - $2,704 34%
Wc Nca Comp $1,352 - $2,704 34%
Wc New York $1,352 - $2,704 34%
Wc New York Special Funds $1,352 - $2,704 34%
Wc North American Rishces $1,352 - $2,704 34%
Wc Northeast Health $1,352 - $2,704 34%
Wc Notre Dame $1,352 - $2,704 34%
Wc Novanet $1,352 - $2,704 34%
Wc Occ Health Allen $1,352 - $2,704 34%
Wc Ohio Bureau $1,352 - $2,704 34%
Wc One Call Medical $1,352 - $2,704 34%
Wc Paradigm $1,352 - $2,704 34%
Wc Peerless $1,352 - $2,704 34%
Wc Pma $1,352 - $2,704 34%
Wc Price Chopper $1,352 - $2,704 34%
Wc Procura Management $1,352 - $2,704 34%
Wc Qualcare $1,352 - $2,704 34%
Wc Quiktrip $1,352 - $2,704 34%
Wc Rev Claims $1,352 - $2,704 34%
Wc Risico $1,352 - $2,704 34%
Wc Rural Mutual $1,352 - $2,704 34%
Wc Saif Oregon $1,352 - $2,704 34%
Wc Secura $1,352 - $2,704 34%
Wc Sedgwick $1,352 - $2,704 34%
Wc Sentry $1,352 - $2,704 34%
Wc Sheakley Unicomp $1,352 - $2,704 34%
Wc Smile Lodge $1,352 - $2,704 34%
Wc Society $1,352 - $2,704 34%
Wc Srs $1,352 - $2,704 34%
Wc Taconic (Mro) $1,352 - $2,704 34%
Wc Taconic Farms $1,352 - $2,704 34%
Wc Travelers $1,352 - $2,704 34%
Wc Triad Group $1,352 - $2,704 34%
Wc Tristar $1,352 - $2,704 34%
Wc Troy Ny $1,352 - $2,704 34%
Wc Tyson $1,352 - $2,704 34%
Wc Unified Health Services $1,352 - $2,704 34%
Wc United Heartland $1,352 - $2,704 34%
Wc Us Dept Of Labor $1,352 - $2,704 34%
Wc Walmart $1,352 - $2,704 34%
Wc West Bend $1,352 - $2,704 34%
Wc West Bend Mutual/Argent $1,352 - $2,704 34%
Wc Winnebago Industries $1,352 - $2,704 34%
Wc Yankee Trails $1,352 - $2,704 34%
Wc York Risk $1,352 - $2,704 34%
Wc Zenith $1,352 - $2,704 34%
Wc Zurich $1,352 - $2,704 34%
Asr Health Benefits $4,605 115%
Christian Brother Services $4,605 115%
Coventry $4,605 115%
First Health $4,605 115%
Luminare Health $4,605 115%
Medical Mutual $4,605 115%
Webtpa $4,605 115%
Medica $6,307 - $9,461 158%
Nova $7,566 189%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3421 West Ninth Street, Waterloo, IA 50702
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals