CMS Price Transparency Data

Breast lump removal

Facility: Harrison County Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $374
Cash Discount Price: $560
vs. Medicare Baseline: 0.09x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Harrison County Hospital is $374. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $560. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.09x the Medicare baseline. Located in 245 Atwood Street, Corydon, IN.

Cash / Self-Pay

$560

Average discount available for prompt cash payment at this facility.

Insurance Median

$374

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: $560 (14%)

Insurance Median: $374 (9%)

Cash: $560 (14% of Medicare)

Ins. Median: $374 (9% 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
Tricare	$341	9%
Aetna	$347 - $375	9%
Cigna	$354	9%
Sagamore-All Plans	$354	9%
UnitedHealthcare	$356 - $465	9%
Blue Cross Blue Shield	$371 - $465	9%
Buckeye Exchange-All Plans	$371	9%
Caresource Mcaid Hip	$371	9%
Caresource Mcr Adv	$371	9%
Mdwise Mcaid Hip	$371	9%
Mhs Exchange-All Other Plans	$371	9%
Mhs Mcaid Hip	$371	9%
Passport Mcr Adv	$371	9%
Mhs Mcr Adv	$374	9%
Caresource Mcaid Hhw	$375	9%
Mdwise Mcaid Hhw/Hcc - All Other Plans	$375	9%
Communicare Adv-All Plans	$378	9%
Caresource Exchange-All Other Plans	$389	10%
Mhs Mcaid Hhw/Hcc	$465	12%
Passport Mcaid-All Other Plans	$465	12%
Siho Exchange	$482	12%
Siho One Southern	$482	12%
Siho Ppo/Hmo - All Other Plans	$482	12%
Encore Encircle	$501	13%
Encore Ppo - All Other Plans	$501	13%
Beech Street Comm-All Plans	$794	20%
First Health-All Plans	$794	20%
Multiplan-All Plans	$841	21%

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 $560.
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 Harrison County Hospital 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.