CMS Price Transparency Data

Breast lump removal

Facility: Rockcastle County Hospital, Inc.

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $649
  • Cash Discount Price: $581
  • vs. Medicare Baseline: 0.16x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Rockcastle County Hospital, Inc. is $649. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $581. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.16x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$581

Average discount available for prompt cash payment at this facility.

Insurance Median
$649

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: $581 (15%)
Insurance Median: $649 (16%)
Cash: $581 (15% of Medicare)
Ins. Median: $649 (16% 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
Passport Hp Hmo - All Plans $206 5%
Caresource Mcaid $264 7%
Coventry Mcaid-All Plans $264 7%
Medicaid / KanCare $264 7%
Molina Mcaid $264 7%
UnitedHealthcare $264 - $350 7%
Humana $322 - $3,674 8%
Blue Cross Blue Shield $520 - $3,674 13%
Multiplan-All Plans $649 16%
Prime Health Services-All Plans $649 16%
Integrated Hp-All Plans $680 17%
Corvel - All Plans $688 17%
Center Care-All Plans $726 18%
Cigna $741 19%
Tricare $2,755 69%
Caresource Mcr Adv-All Other Plans $3,674 92%
Molina Marketplace - All Other Plans $3,674 92%
Molina Mcr Adv $3,674 92%
Signature Mcr Adv-All Plans $3,674 92%
Wellcare Mcr Adv-All Other Plans $3,674 92%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals