CMS Price Transparency Data

Breast lump removal

Facility: Sarah Bush Lincoln Health Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $877
  • Cash Discount Price: $1,370
  • vs. Medicare Baseline: 0.22x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Sarah Bush Lincoln Health Center is $877. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,370. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.22x the Medicare baseline. Located in 1000 Health Center Drive P O Box 372, Mattoon, IL.
Cash / Self-Pay
$1,370

Average discount available for prompt cash payment at this facility.

Insurance Median
$877

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: $1,370 (34%)
Insurance Median: $877 (22%)
Cash: $1,370 (34% of Medicare)
Ins. Median: $877 (22% 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
Aetna $421 - $1,480 11%
Bc Comm Mmai $421 11%
Beacon Health Options Behav-All Plans $421 11%
Hlth Alliance Mcr Adv $421 11%
Humana $421 - $429 11%
Meridian Mcaid $421 11%
Meridian Mmai-All Other Plans $421 11%
Molina Mmai-All Other Plans $421 11%
Tricare $421 11%
UnitedHealthcare $421 - $1,365 11%
Va Ccn-All Plans $421 11%
Wellcare Med Adv-All Plans $421 11%
Bc Med Adv Ppo/Hmo $433 11%
Plain Church Mg-All Plans $438 - $658 11%
Mennonite-All Plans $493 - $740 12%
Blue Cross Blue Shield $514 - $858 13%
First Health-All Plans $622 16%
Eiu Athlete-All Other Plans $767 - $1,151 19%
Multiplan-All Plans $778 19%
Healthscope-All Plans $811 - $1,217 20%
Rural King-All Plans $811 - $1,217 20%
Bc Comm Care Mcaid $828 21%
Hlth Alliance Mcaid $828 21%
Molina Mcaid $828 21%
Hope Trust-All Plans $877 - $1,315 22%
Eiu Student $899 - $1,348 22%
Allied National-All Plans $921 - $1,381 23%
Companion Life-All Plans $921 - $1,381 23%
Innovative Hlthware-All Plans $932 - $1,397 23%
Healthlink Hmo $943 - $1,414 24%
Healthlink Ppo - All Other Plans $943 - $1,414 24%
Cigna $986 - $1,480 25%
Consociate-All Plans $986 - $1,480 25%
Cphp-All Plans $986 - $1,480 25%
Beech Street-All Plans $1,008 - $1,512 25%
Hfn-All Plans $1,008 - $1,512 25%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Health Center Drive P O Box 372, Mattoon, IL 61938
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals