CMS Price Transparency Data

Breast lump removal

Facility: Uofl Health - Shelbyville Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $3,643
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Uofl Health - Shelbyville Hospital is $3,643. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.91x the Medicare baseline. Located in 727 Hospital Drive, Shelbyville, KY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,643

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%)

Insurance Median: $3,643 (91%)

Ins. Median: $3,643 (91% 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
Blue Cross Blue Shield	$1,905 - $5,891	48%
UnitedHealthcare	$2,723	68%
Humana	$3,171 - $3,590	79%
Senior Care Communty Of Ky	$3,337	83%
Devoted	$3,504	88%
Cigna	$3,590	90%
Essence Health	$3,590	90%
Va Ccn	$3,590	90%
Signature	$3,697	92%
Communicare	$3,769	94%
Passport	$3,769 - $4,539	94%
Velocity	$4,172 - $6,007	104%
Key Benefit Administrators	$4,667	117%
Wellcare	$4,672	117%

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 $X.
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 Uofl Health - Shelbyville 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.