Breast lump removal
Facility: Centura St. Catherine-Dodge City
Billing Code: 19120 (CPT)
- CPT Billing Code: 19120
- Insurance Median: $375
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.09x 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 |
|---|---|---|
| Humana | $375 | 9% |
| Kaiser | $375 | 9% |
| Medicare (plans) | $375 | 9% |
| Kansas Health | $375 | 9% |
| Aetna | $375 | 9% |
| Blue Cross Blue Shield | $375 | 9% |
| Cigna | $375 | 9% |
Consumer Guidance & Cost Commentary
For the CPT code 19120, representing a breast lump removal, the negotiated rates across seven payers in Dodge City, KS, are consistently $375. This amount is significantly lower than the Medicare benchmark of $4,000.24, which serves as the federal baseline for the true cost of this procedure. While commercial contracts cap payments at $375, patients should be aware that cash-pay options or prompt-pay discounts may offer further savings, particularly if their insurance deductible has not yet been met. It is important to verify with the facility whether a "self-pay" classification is available before scheduling, as this can sometimes result in a lower out-of-pocket cost than the standard negotiated rate.
This facility, Centura St. Catherine-Dodge City, is a proprietary acute care hospital located in Dodge City, Kansas. The data reflects a vintage of June 2026 and indicates that the negotiated rate of $375 is substantially below the typical commercial markup range of 200% to 300% of Medicare, aligning more closely with fair pricing standards of 120% to 150%. Patients should request an itemized bill to ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors. If a balance bill arises from out-of-network ancillary services, the No Surprises Act may provide protection against unexpected costs, so disputing such charges with the insurer is a recommended step before making any payment.