CMS Price Transparency Data

Breast lump removal

Facility: Goshen Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,693
  • Cash Discount Price: $7,714
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Goshen Hospital is $3,693. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,714. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.92x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.
Cash / Self-Pay
$7,714

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,693

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: $7,714 (193%)
Insurance Median: $3,693 (92%)
Cash: $7,714 (193% of Medicare)
Ins. Median: $3,693 (92% 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
Advantage Health Solutions $3,693 92%
Aetna $3,693 92%
Atrio Health Plans $3,693 92%
Bc Federal Employee $3,693 92%
Bc Mcr Advantage Ppo $3,693 92%
Blue Cross Blue Shield $3,693 92%
Buckeye Health Plan $3,693 92%
Cigna $3,693 92%
Coventry Health And Life $3,693 92%
Emblem Health $3,693 92%
Freedom Healthcare $3,693 92%
Geisinger Health Plan $3,693 92%
Health First $3,693 92%
Healthspring $3,693 92%
Humana $3,693 92%
Iehp Empire Health Plan $3,693 92%
Independent Care Health Plan $3,693 92%
Kaiser Permanente $3,693 92%
Mcr Advantra Freedom $3,693 92%
Mcr Allwell Mhs $3,693 92%
Mcr Banner Health $3,693 92%
Mcr Complete $3,693 92%
Mcr Complete Ppo $3,693 92%
Mcr Complete Wellmed $3,693 92%
Mcr Health Alliance $3,693 92%
Mcr Health Partners Plans $3,693 92%
Mcr Medical Mutual Of Ohio $3,693 92%
Mcr Passport Advantage $3,693 92%
Mcr Secure Horizons Ppo $3,693 92%
Mcr Texan Plus $3,693 92%
Mcr Upmc For Life $3,693 92%
Medicare (plans) $3,693 - $3,914 92%
Meridian Complete $3,693 92%
Optimum Healthcare $3,693 92%
Paramount Elite $3,693 92%
Primetime Health Plan $3,693 92%
Simply Complete Hmo $3,693 92%
The Umwa H&R Funds $3,693 92%
Todays Options Pyramid Life $3,693 92%
Trillium Advantage $3,693 92%
Ucare For Seniors $3,693 92%
Ucare Minnesota $3,693 92%
UnitedHealthcare $3,693 92%
Wellcare $3,693 92%
Champva $3,800 95%
Tricare $3,800 95%
Mcr Devoted Health Plan $3,914 98%
Mcr Provider Partners Hlth Pln $4,180 104%
Ambetter / Centene $5,321 133%
Mkt Caresource $5,321 133%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 High Park Ave, Goshen, IN 46526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals