CMS Price Transparency Data

Breast lump removal

Facility: Lake Charles Memorial Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,125
  • Cash Discount Price: $3,280
  • vs. Medicare Baseline: 0.78x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Lake Charles Memorial Hospital is $3,125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,280. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.78x the Medicare baseline. Located in 1701 Oak Park Blvd, Lake Charles, LA.
Cash / Self-Pay
$3,280

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,125

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: $3,280 (82%)
Insurance Median: $3,125 (78%)
Cash: $3,280 (82% of Medicare)
Ins. Median: $3,125 (78% 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
United_Healthcare $1,665 42%
Meritain $2,460 61%
Verity $2,624 66%
Aetna $3,125 - $11,064 78%
Blue Cross Blue Shield $3,125 78%
Champus_Va $3,125 78%
Cigna $3,125 - $4,100 78%
Medicare (plans) $3,125 78%
Tricare $3,125 78%
Veterans_Administration $3,125 78%
Veterans_Choice-Triwest $3,125 78%
Humana $3,188 - $10,939 80%
Ppo_Plus_ $3,280 82%
Phcs $3,827 96%
United_Healthcare_Behavorial_Health $3,827 96%
Lwcc $4,182 105%
First_Health $4,374 109%
Workers_Compensation $4,920 123%
Blue_Cross_Blue_Shield_La $5,451 136%
Coushatta_Tribe_Dept_Of_Health $5,626 141%
Vantage_Commercial $7,188 180%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Oak Park Blvd, Lake Charles, LA 70601
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals