Breast lump removal
Facility: Cheyenne County Hospital
Billing Code: 19120 (CPT)
- CPT Billing Code: 19120
- Insurance Median: $2,226
- Cash Discount Price: $1,594
- vs. Medicare Baseline: 0.56x 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 |
|---|---|---|
| Healthy Blue Mcr Adv | $289 - $2,257 | 7% |
| Tricare | $289 - $2,257 | 7% |
| UnitedHealthcare | $289 - $3,135 | 7% |
| Aetna | $289 - $2,978 | 7% |
| Choice Care - All Plans | $319 - $2,280 | 8% |
| First Health - All Plans | $431 - $2,194 | 11% |
| Firstguard - All Plans | $493 - $2,508 | 12% |
| Wppa - All Plans | $554 - $2,822 | 14% |
| Preferred Hc - All Plans | $585 - $2,978 | 15% |
| Cpm - All Plans | $585 - $2,978 | 15% |
| Midlands Choice - All Plans | $597 - $3,041 | 15% |
| Ppo Next - All Plans | $604 - $3,072 | 15% |
| Health Partners - All Plans | $604 - $3,072 | 15% |
| Unicare - All Plans | $604 - $3,072 | 15% |
| Integrated Hp - All Plans | $604 - $3,072 | 15% |
| Healthwave Mcaid - All Plans | $616 - $3,135 | 15% |
| Childrens Mercy - All Plans | $616 - $3,135 | 15% |
| Healthy Blue Mcaid - All Other Plans | $616 - $3,135 | 15% |
| Providers Care-All Plans | $924 - $4,702 | 23% |
| Blue Cross Blue Shield | $2,355 | 59% |
Consumer Guidance & Cost Commentary
For the CPT code 19120, representing a breast lump removal, Cheyenne County Hospital in St. Francis, KS, lists a gross charge of $1,875.00. The facility's cash median price is $1,594.00, which is lower than the median negotiated rate of $2,257.00 paid by insurers. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify if their specific insurance plan falls within the 20 payers listed, as allowed amounts range from $289 to $4,702 depending on the carrier. It is important to note that cash-pay rates can sometimes be more cost-effective than insurance negotiated rates, particularly for patients with high-deductible plans where the insurer's allowed amount might exceed the cash price.
To ensure you receive the most accurate billing, we recommend requesting an itemized bill that details every CPT code and unit cost, as summary bills often obscure individual charges. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if paid in full upfront. Since the facility is located in Kansas, you may also wish to compare these rates against state or county averages to confirm fair pricing, keeping in mind that commercial rates often include administrative overhead that can inflate the baseline price.