CMS Price Transparency Data

Breast lump removal

Facility: Steele Memorial Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $331
Cash Discount Price: $601
vs. Medicare Baseline: 0.08x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Steele Memorial Medical Center is $331. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $601. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.08x the Medicare baseline. Located in 203 South Daisy Street, Salmon, ID.

Cash / Self-Pay

$601

Average discount available for prompt cash payment at this facility.

Insurance Median

$331

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: $601 (15%)

Insurance Median: $331 (8%)

Cash: $601 (15% of Medicare)

Ins. Median: $331 (8% 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
Aetna	$152 - $369	4%
Pacific Source Mcr Adv	$159 - $369	4%
Windsor Hp Mcr Adv - All Plans	$159 - $369	4%
Select Health Mcr Adv	$160 - $373	4%
Blue Cross Blue Shield	$162 - $424	4%
Liberty Healthshare - All Plans	$270 - $590	7%
Pacific Source - All Other Plans	$304	8%
Mountain Health Co-Op - All Plans	$321	8%
Regence Blue Shield - All Plans	$321	8%
Select Health Inc - All Other Plans	$321 - $828	8%
UnitedHealthcare	$321 - $455	8%
Multiplan - All Plans	$331 - $1,239	8%
Three Rivers - All Plans	$331	8%
Ichn, Llc - All Plans	$338 - $1,264	8%
Interwest Health - All Plans	$865	22%

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 $601.
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 Steele Memorial 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.