CMS Price Transparency Data

Breast lump removal

Facility: Jefferson County Health Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $653
  • Cash Discount Price: $854
  • vs. Medicare Baseline: 0.16x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Jefferson County Health Center is $653. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $854. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.16x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$854

Average discount available for prompt cash payment at this facility.

Insurance Median
$653

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: $854 (21%)
Insurance Median: $653 (16%)
Cash: $854 (21% of Medicare)
Ins. Median: $653 (16% 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
UnitedHealthcare $484 - $1,281 12%
Tricare $552 14%
Amerigroup Mcr Adv $569 14%
Humana $569 14%
Iowa Total Care Comm - All Other Plans $569 14%
Iowa Total Care Mcr $569 14%
Molina Mcr Adv $569 14%
Iowa Total Care Mcaid $598 15%
Molina Mcaid/Chip $598 15%
Medicaid / KanCare $610 15%
Aetna $697 - $1,281 17%
Medicare (plans) $697 17%
Midlands New Product $1,167 29%
Coventry Commercial Hmo $1,210 30%
Coventry Commercial Ppo - All Other Plans $1,281 32%
Midlands Choice-All Other Plans $1,281 32%
Molina Marketplace - All Other Plans $1,423 36%
Wellmark Hmo $2,595 65%
Wellmark Indemnity/Ppo - All Other Plans $2,855 71%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals