CMS Price Transparency Data
Breast lump removal
Facility: Claiborne Memorial Medical Center
Billing Code: 19120 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 19120
- Insurance Median: $3,300
- Cash Discount Price: $3,300
- vs. Medicare Baseline: 0.82x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Claiborne Memorial Medical Center is $3,300. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,300. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.82x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$3,300
Average discount available for prompt cash payment at this facility.
Insurance Median
$3,300
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: $3,300 (82%)
Insurance Median: $3,300 (82%)
Cash: $3,300 (82% of Medicare)
Ins. Median: $3,300 (82% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ambetter / Centene | $320 | 8% |
| Medicaid / KanCare | $320 - $1,418 | 8% |
| Aetna | $536 - $2,145 | 13% |
| Amerihealth Caritas La | $536 - $1,418 | 13% |
| Community Health Solution | $536 - $1,418 | 13% |
| Correctcare Intergrated | $536 - $1,418 | 13% |
| Healthy Blue | $536 - $1,418 | 13% |
| Humana | $536 - $3,300 | 13% |
| Louisiana Hc Connections | $536 - $1,418 | 13% |
| Magellan Services | $536 - $1,418 | 13% |
| UnitedHealthcare | $536 - $1,544 | 13% |
| Sedgwick Claims Mgmt Serv | $648 - $2,970 | 16% |
| Workman'S Comp | $648 - $2,970 | 16% |
| Commercial Insurance | $1,250 - $3,300 | 31% |
| Meritain Health | $1,250 - $2,145 | 31% |
| All Savers | $1,544 | 39% |
| Golden Rule Ins Co | $1,544 | 39% |
| United Behavioral Health | $1,544 | 39% |
| Coventry Healthcare | $1,980 | 49% |
| Geha | $2,310 | 58% |
| Health Plus Of La | $2,310 - $2,475 | 58% |
| Apwu Healthplan | $2,475 | 62% |
| Cigna | $2,475 | 62% |
| Great West Healthcare | $2,475 | 62% |
| Phcs | $2,640 | 66% |
| Ppo Plus | $2,640 | 66% |
| Aarp | $3,300 | 82% |
| Accordia National | $3,300 | 82% |
| Aflac | $3,300 | 82% |
| Alameda Alliance Forhealt | $3,300 | 82% |
| American Pioneer | $3,300 | 82% |
| Benefit Management | $3,300 | 82% |
| Benesys Inc | $3,300 | 82% |
| Business Guarantor | $3,300 | 82% |
| Chubb | $3,300 | 82% |
| Commercial Sr. Care | $3,300 | 82% |
| Employee Benefit Services | $3,300 | 82% |
| Family Life Insurance Co | $3,300 | 82% |
| Farm Bureau Insurance | $3,300 | 82% |
| Fiserv Health Benefit | $3,300 | 82% |
| Gmp | $3,300 | 82% |
| Group And Pension Admin | $3,300 | 82% |
| Group Resources | $3,300 | 82% |
| Haik Minvielle And Grubbs | $3,300 | 82% |
| Harrington Benefit Svs | $3,300 | 82% |
| Health Design Plus | $3,300 | 82% |
| Health Plan | $3,300 | 82% |
| Healthscope Benefits | $3,300 | 82% |
| Insurance Management Admi | $3,300 | 82% |
| Jefferson National | $3,300 | 82% |
| John Alden Health Ins | $3,300 | 82% |
| John Hancock | $3,300 | 82% |
| Liberty Mutual | $3,300 | 82% |
| Mailhandlers Benefit Plan | $3,300 | 82% |
| Manhattan Life Ins Co | $3,300 | 82% |
| Mega Life And Health | $3,300 | 82% |
| Msa Careguard | $3,300 | 82% |
| Mutual Of Omaha | $3,300 | 82% |
| Nalc Health Benefit Plan | $3,300 | 82% |
| Naphcare Inc. | $3,300 | 82% |
| New Era Life Ins Co | $3,300 | 82% |
| Physicians Mutual | $3,300 | 82% |
| Principal Financial Group | $3,300 | 82% |
| Prudential Healthcare | $3,300 | 82% |
| Self Pay | $3,300 | 82% |
| State Farm | $3,300 | 82% |
| State Farm Insurance | $3,300 | 82% |
| State Mutual Insurance Co | $3,300 | 82% |
| Sterling Investors Life | $3,300 | 82% |
| Tower Life | $3,300 | 82% |
| Transamerica Premier Ins | $3,300 | 82% |
| United American | $3,300 | 82% |
| United Comm Travelers | $3,300 | 82% |
| United Teachers | $3,300 | 82% |
| Usable Administrator | $3,300 | 82% |
| Visn 16 Cfu | $3,300 | 82% |
| Wausau Benefits | $3,300 | 82% |
| Webtpa | $3,300 | 82% |
| Wells Fargo | $3,300 | 82% |
| Woodmen Of The World | $3,300 | 82% |
| Blue Cross Blue Shield | $5,424 | 136% |