Breast lump removal
Facility: Children'S Mercy South
Billing Code: 19120 (CPT)
- CPT Billing Code: 19120
- Insurance Median: $1,093
- Cash Discount Price: $894
- vs. Medicare Baseline: 0.27x 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 |
|---|---|---|
| UnitedHealthcare | $374 - $3,337 | 9% |
| Healthy Blue | $399 - $9,463 | 10% |
| Medicaid / KanCare | $402 - $1,445 | 10% |
| Home State Health | $493 - $8,315 | 12% |
| Quiktrip | $497 - $3,233 | 12% |
| Healthlink | $510 - $4,370 | 13% |
| Health Midwest Comprehensive Care | $558 - $3,233 | 14% |
| Blue Cross Blue Shield | $562 - $3,675 | 14% |
| American Healthcare Alliance | $597 - $4,221 | 15% |
| Wppa Providrs Care | $606 - $3,228 | 15% |
| Multiplan | $631 - $3,774 | 16% |
| Aetna | $634 - $3,377 | 16% |
| Medica | $724 - $2,895 | 18% |
| Humana | $763 - $3,302 | 19% |
| Cigna | $766 - $3,451 | 19% |
| Orscheln | $771 - $3,228 | 19% |
| Wellfit/Centrus | $771 - $3,228 | 19% |
| Nebraska Furniture Mart | $787 - $3,228 | 20% |
| Centivo | $794 - $3,228 | 20% |
| Coventry Health Care Of Kansas | $801 - $3,675 | 20% |
| Mercy Health | $907 - $3,724 | 23% |
| Coxhealth Network | $919 - $3,675 | 23% |
| National Preferred Provider Network | $1,093 - $4,469 | 27% |
Consumer Guidance & Cost Commentary
Children's Mercy South, located at 5808 W 110th Street in Overland Park, Kansas, offers a breast lump removal procedure with a cash median price of $894. This cash rate is notably lower than the facility's gross chargemaster rate of $1,863 and falls significantly below the Medicare benchmark of $4,000.24 for this service. While the facility is a voluntary non-profit children's hospital in Kansas, specific state or county average data for this procedure was not provided in the available records.
For insured patients, the financial landscape varies by coverage type. The median negotiated rate is $1,093, which exceeds the cash price, suggesting that self-pay might be more economical for those with high-deductible plans if they can secure a cash discount. Insurance payers show a wide range of costs, with UnitedHealthcare plans ranging from $374 to $3,337 and Blue Cross Blue Shield plans ranging from $562 to $3,675. Patients should verify their specific plan's allowed amount and inquire about prompt-pay discounts before scheduling, as paying upfront can sometimes bypass administrative fees associated with insurance claims processing.