CMS Price Transparency Data

Breast lump removal

Facility: Munson Healthcare Grayling Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $599
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.15x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Munson Healthcare Grayling Hospital is $599. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.15x the Medicare baseline. Located in 1100 E Michigan Ave, Grayling, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$599

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%)
Insurance Median: $599 (15%)
Ins. Median: $599 (15% 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
Blue Cross Blue Shield $124 - $3,192 3%
Mclaren Health Plan $272 - $3,901 7%
Meridian $272 - $2,040 7%
Molina $272 - $4,213 7%
Priority Health $272 - $3,901 7%
UnitedHealthcare $272 - $3,901 7%
Aetna $400 - $3,901 10%
Atrium King Centre Skilled Nursing Services $400 - $3,901 10%
Blue Care Network $400 - $3,901 10%
Hap (Health Alliance Plan) $400 - $3,901 10%
Humana $400 - $3,901 10%
Medicare (plans) $400 - $3,901 10%
Northern Michigan Mennonite Group $400 - $3,901 10%
Promedica $400 - $3,901 10%
Wellcare (Meridian) $400 - $3,901 10%
Wellspring Lutheran Services Skilling Nursing Services $400 - $3,901 10%
Michigan Amish Medical Board $460 - $3,901 11%
Cofinity $545 14%
Provider Network Of America Group Health $559 14%
Cigna $582 - $1,632 15%
Asr/Physicians Care $599 15%
Nomi Health $639 16%
Employee Benefits Logistics $679 17%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 E Michigan Ave, Grayling, MI 49738
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals