Breast lump removal
Facility: Ascension Via Christi Hospitals Wichita, Inc.
Billing Code: 19120 (CPT)
- CPT Billing Code: 19120
- Insurance Median: $393
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.10x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Early Detection Works | $393 | 10% |
Consumer Guidance & Cost Commentary
For the CPT code 19120, representing a breast lump removal at Ascension Via Christi Hospitals Wichita, Inc., the facility's negotiated rate is $393.00. This amount is significantly lower than the Medicare benchmark of $4,000.24, reflecting a standard commercial discount structure where negotiated rates typically range between 120% and 150% of the Medicare base cost. While the facility is located in Wichita, Kansas, and serves the 67214 zip code, the data indicates a single payer, Early Detection Works, with a uniform payment of $393.00 across its one plan. Because the negotiated rate is fixed and does not vary by payer tier in this specific dataset, patients should verify if their own insurance plan falls within this single contract to ensure they are not subject to higher out-of-network charges or balance billing.
Patients should be aware that cash-pay options may offer further savings if they do not have insurance or have high-deductible plans where the insurance allowed amount exceeds the cash price. Although the cash median and median paid values are not currently listed for this specific procedure, the facility offers a prompt-pay discount mechanism that can reduce the final bill by 20% to 50% if paid in full upfront. To maximize these savings, consumers should request a self-pay classification before scheduling and sign a waiver of insurance submission to bypass the administrative overhead that often inflates commercial rates. Additionally, if a detailed itemized bill is received, patients should review it for unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute sent