CMS Price Transparency Data

Breast lump removal

Facility: Lutheran Hospital of Indiana

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $706
  • Cash Discount Price: $444
  • vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Lutheran Hospital of Indiana is $706. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $444. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.18x the Medicare baseline. Located in 7950 W Jefferson Blvd, Fort Wayne, IN.
Cash / Self-Pay
$444

Average discount available for prompt cash payment at this facility.

Insurance Median
$706

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: $444 (11%)
Insurance Median: $706 (18%)
Cash: $444 (11% of Medicare)
Ins. Median: $706 (18% 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
Physicians Health Plan Of Northern Indiana $128 - $13,092 3%
Ky Work Comp $131 - $8,356 3%
Amish Aid $156 - $9,948 4%
Lutheran Preferred Network $156 - $19,896 4%
Self Pay $156 - $9,948 4%
Cigna $168 - $12,037 4%
Php Freedom Network $173 - $11,006 4%
Blue Cross Blue Shield $193 - $17,024 5%
Aetna $208 - $15,784 5%
Lutheran Preferred $208 - $1,307 5%
Sagamore $237 - $17,940 6%
Encore Ppo $254 - $16,215 6%
Lutheran Network $260 - $16,580 6%
One Call Care Diagnostics $371 9%
Multiplan $380 - $27,523 9%
Prime Health Services $390 - $24,870 10%
Encore Health Network $426 - $29,844 11%
Advantage Health Solutions $432 - $27,523 11%
Bccp In $464 12%
Veterans Eval Services $465 12%
Allied Benefit Systems $468 - $29,844 12%
Evolutions $468 - $29,844 12%
Care Source $1,905 48%
Humana $1,905 - $4,076 48%
Managed Health Services $1,905 - $8,285 48%
Medicaid / KanCare $1,905 48%
UnitedHealthcare $1,905 - $8,192 48%
Tricare $3,935 98%
Iu Health Plan $4,076 102%
Medicare (plans) $4,076 102%
Department Of Veterans Affairs $4,143 104%
Node Hospice Non Par Agree $4,143 104%
Node Va $4,143 104%
Node Devoted Health Mcr Adv $4,158 104%
In Dept Of Correction $4,308 108%
Node Pphp Mcr Adv $4,350 109%
Us Department Of Labor $5,178 129%
Lutheran Advanced Network $6,214 155%
Node Lutheran Network $6,214 - $7,250 155%
Node Lutheran Preferred Fixed 2 $6,214 155%
Align Network $6,628 166%
Encore Work Comp In $7,457 186%
Node Encore Kba Epo $9,942 249%
Node Encore Kba Ppo $12,428 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7950 W Jefferson Blvd, Fort Wayne, IN 46804
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals