CMS Price Transparency Data

Breast lump removal

Facility: Deaconess Henderson Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $725
  • Cash Discount Price: $663
  • vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Deaconess Henderson Hospital is $725. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $663. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.18x the Medicare baseline. Located in 1305 N Elm St, Henderson, KY.
Cash / Self-Pay
$663

Average discount available for prompt cash payment at this facility.

Insurance Median
$725

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%)
Cash / Self-Pay: $663 (17%)
Insurance Median: $725 (18%)
Cash: $663 (17% of Medicare)
Ins. Median: $725 (18% 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.

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
Aetna $264 - $3,348 7%
Medicaid / KanCare $264 - $469 7%
UnitedHealthcare $264 - $7,000 7%
Wellcare Ky $264 - $4,017 7%
Humana $266 - $3,348 7%
Blue Cross Blue Shield $292 - $3,348 7%
Wellcare Il $292 - $3,348 7%
Medicare (plans) $380 - $3,348 9%
Mhs Mco $380 - $3,348 9%
Molina Healthcare Of Ky $380 - $3,348 9%
Molina Healthcare Of Ky - Exchange $380 - $3,348 9%
Mytru Advantage $380 - $3,348 9%
Umwa $380 - $3,348 9%
Caresource In $469 12%
Caresource In Marketplace $494 - $5,022 12%
Wellcare Ky Commercial Exchange $494 - $6,863 12%
Alliance Coal $524 - $5,022 13%
Center Care Narrow $608 15%
Center Care Open Access $608 15%
Noncontracted $608 - $5,356 15%
Ky Racing Health & Welfare Fund $663 17%
Self-Pay $663 17%
First Health Network (Coventry) $725 18%
Healthlink $725 18%
Iu Health Plans $725 18%
Phcs/Multiplan $725 18%
Sagamore $725 18%
Encircle/Encore Combined $739 18%
Encircle/Encore Prime $739 18%
Cigna $1,137 28%
Claimdoc $1,137 - $8,034 28%
Hopetrust $1,137 - $8,034 28%
Hstechnology $1,137 - $8,034 28%
Amish And Mennonite Of Western Ky $1,232 - $5,022 31%
Coventry National Network $1,516 38%
Webster County Detention Center $1,516 38%
Henderson County Detention Center $1,706 43%
One Care $7,365 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 N Elm St, Henderson, KY 42420
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals