CMS Price Transparency Data

Breast lump removal

Facility: University of Michigan Health System

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $928
  • Cash Discount Price: $4,170
  • vs. Medicare Baseline: 0.23x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at University of Michigan Health System is $928. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,170. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.23x the Medicare baseline. Located in 1500 E Medical Center Drive, Spc 5474, Ann Arbor, MI.
Cash / Self-Pay
$4,170

Average discount available for prompt cash payment at this facility.

Insurance Median
$928

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: $4,170 (104%)
Insurance Median: $928 (23%)
Cash: $4,170 (104% of Medicare)
Ins. Median: $928 (23% 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
Aetna $272 - $7,697 7%
Ambetter / Centene $272 - $336 7%
Blue Cross Blue Shield $272 - $4,983 7%
Buckeye Community Health Plan $272 - $336 7%
Hap Midwest $272 - $336 7%
Mclaren Health Plan Inc $272 - $7,287 7%
Medicaid / KanCare $272 - $5,831 7%
Molina Healthcare Of Michigan Inc $272 - $469 7%
Priority Health $272 - $11,662 7%
UnitedHealthcare $272 - $8,513 7%
Amerihealth Michigan Inc $356 - $368 9%
Huron Valley Pace $423 - $437 11%
Blue Care Network Of Michigan $445 - $4,983 11%
Health Alliance Plan $445 - $460 11%
Humana $445 - $460 11%
Medigold Trinity Health Plan Of Michigan $445 - $460 11%
Meridian Health Plan Of Michigan Inc $445 - $460 11%
Paramount Elite-Ohio $445 - $460 11%
Paramount Health Care $445 - $9,679 11%
Thome Pace $445 - $460 11%
Triwest $445 - $460 11%
Veteran Affairs Community Care Program $445 - $460 11%
Medicare (plans) $451 - $467 11%
Zing Health $467 - $483 12%
Point Comfort Underwriters Unaccompanied Children Program $532 - $5,015 13%
Priority Health [1038] $569 - $7,814 14%
Metrocare $581 - $5,481 15%
Hap [1023] $679 - $8,746 17%
Plain Church Group $742 - $6,997 19%
Employee Benefit Logistic $756 - $782 19%
First Health $804 - $8,861 20%
Cofinity $816 - $7,944 20%
Confinity Advantage $816 - $7,697 20%
Beaumont Health Network $866 - $8,163 22%
Nomi Health $866 - $8,163 22%
Provider Network Of America $866 - $8,163 22%
First Agency $928 - $8,746 23%
Parkview Health Plan Services $928 - $8,746 23%
Bronson Healthcare Group $1,051 - $9,913 26%
Multiplan $1,051 - $9,913 26%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 E Medical Center Drive, Spc 5474, Ann Arbor, MI 48109
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals