CMS Price Transparency Data

Breast lump removal

Facility: Bayou Bend Health System

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $758
Cash Discount Price: $754
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Bayou Bend Health System is $758. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $754. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.19x the Medicare baseline. Located in 1097 Northwest Blvd, Franklin, LA.

Cash / Self-Pay

$754

Average discount available for prompt cash payment at this facility.

Insurance Median

$758

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: $754 (19%)

Insurance Median: $758 (19%)

Cash: $754 (19% of Medicare)

Ins. Median: $758 (19% 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
Blue Cross Blue Shield	$485 - $4,340	12%
Tricare	$485	12%
UnitedHealthcare	$506 - $538	13%
Aetna	$538 - $732	13%
Dignity Mcr Adv Ip/Op Only-All Plans	$538	13%
Humana	$538 - $700	13%
Sterling Hp Mcr Adv Ip/Op Only-All Plans	$538	13%
Verity Healthnet Mcr Adv Ip/Op Only	$538	13%
Wellcare Mcr Allwell Ip/Op Only-All Plans	$538	13%
Ambetter / Centene	$619	15%
Amerihealth Caritas Mcaid Ip/Op Only-All Plans	$758	19%
La Health Mcaid Ip/Op Only	$758	19%
Verity Healthnet Mcaid Ip/Op Only	$758	19%
Diocese Of Lafaytte Ip/Op Only-All Plans	$808	20%
Gilsbar 360 Ip/Op Only-All Plans	$808	20%
Verity Healthnet Ip/Op Only-All Other Plans	$808	20%
Ccn/First Health Ip/Op Only-All Plans	$862	22%
Integrated Hp Multiplan Ip/Op Only-All Plans	$862	22%
Ppo Plus / Zelis Ip/Op Only-All Plans	$862	22%
Geha Ppo Ip/Op Only-All Plans	$915	23%
Usa Mco Ip/Op Only-All Plans	$915	23%
Galaxy Ip/Op Only-All Plans	$969	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 $754.
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 Bayou Bend Health System 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.