CMS Price Transparency Data

Breast lump removal

Facility: The Women's Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $609
  • Cash Discount Price: $663
  • vs. Medicare Baseline: 0.15x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at The Women's Hospital is $609. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $663. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.15x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.
Cash / Self-Pay
$663

Average discount available for prompt cash payment at this facility.

Insurance Median
$609

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: $663 (17%)
Insurance Median: $609 (15%)
Cash: $663 (17% of Medicare)
Ins. Median: $609 (15% 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 $264 - $725 7%
Humana $264 - $3,398 7%
Passport Molina Ky $264 7%
UnitedHealthcare $264 - $7,419 7%
Wellcare Ky $264 - $3,398 7%
Blue Cross Blue Shield $292 - $12,445 7%
Meridian Health Il $292 - $3,398 7%
Molina Il $292 - $3,398 7%
Caresource $375 - $3,398 9%
Iu Health $375 - $3,398 9%
Mhs $375 - $3,398 9%
Molina Ky $375 - $3,398 9%
Molina Ky Dual $375 - $3,398 9%
Ambetter / Centene $431 - $5,266 11%
Immergrun $452 - $4,077 11%
Caresource Hip $469 12%
Caresource In $469 12%
Mdwise Hip $469 12%
Mhs Behavioral $469 12%
Caresource Marketplace (Just4Me) $487 - $5,096 12%
Hst $506 - $5,096 13%
Alliance Coal $517 13%
Allied National/Zelis - Freedom Plan $525 - $8,324 13%
Claimdoc $544 - $4,927 14%
Patoka Valley Health Care (80/20 Plan) $562 14%
Patoka Valley Health Care (90/10 Plan) $562 14%
Hope Trust $600 - $5,606 15%
Noncontracted $600 - $5,436 15%
One Care $618 15%
Chamber Care $621 16%
Amish $663 - $1,359 17%
Self Pay $663 17%
Cigna $725 18%
Claritev (Formerly Phcs/Mulitplan) $725 18%
First Health/Coventry $725 18%
Healthlink $725 18%
Sagamore $725 18%
Encorecombined $739 18%
Encoreprime $739 18%
Center Care $1,137 28%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4199 Gateway Blvd, Newburgh, IN 47630
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals