CMS Price Transparency Data

Breast lump removal

Facility: Ochsner American Legion Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $265
Cash Discount Price: $415
vs. Medicare Baseline: 0.07x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Ochsner American Legion Hospital is $265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $415. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.07x the Medicare baseline. Located in 1634 Elton Road, Jennings, LA.

Cash / Self-Pay

$415

Average discount available for prompt cash payment at this facility.

Insurance Median

$265

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: $415 (10%)

Insurance Median: $265 (7%)

Cash: $415 (10% of Medicare)

Ins. Median: $265 (7% 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
Aetna	$152 - $536	4%
Blue Cross Blue Shield	$152 - $588	4%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$152 - $294	4%
Humana	$152 - $352	4%
Medicare (plans)	$152 - $294	4%
Ochsner Health Plan	$152 - $294	4%
UnitedHealthcare	$152 - $606	4%
Wellcare Of Louisiana	$152 - $294	4%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$157 - $303	4%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$240 - $352	6%
Healthy Blue (Healthy Louisiana)	$240 - $352	6%
Louisiana Healthcare Connections (Healthy Louisiana)	$240 - $352	6%
Verity Commercial And First Choice Network	$395	10%
Tricare	$490	12%
Zelis	$513	13%
Louisiana Workers' Compensation Corporation (Lwcc)	$583	15%
Provider Network Of America	$597	15%
Healthcomp & Personify Health (Formerly Gilsbar)	$678	17%
Cigna	$971	24%

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 $415.
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 Ochsner American Legion 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.