CMS Price Transparency Data

Breast lump removal

Facility: Covenant Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $578
  • Cash Discount Price: $608
  • vs. Medicare Baseline: 0.14x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Covenant Medical Center is $578. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $608. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.14x the Medicare baseline. Located in 1447 N Harrison, Saginaw, MI.
Cash / Self-Pay
$608

Average discount available for prompt cash payment at this facility.

Insurance Median
$578

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: $608 (15%)
Insurance Median: $578 (14%)
Cash: $608 (15% of Medicare)
Ins. Median: $578 (14% 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
Health Advantage Mclaren Employee $321 - $391 8%
Priority Health E $328 - $400 8%
Physicians Health Plan $393 - $478 10%
Priority Health $393 - $4,000 10%
Mclaren Health Advantage $418 - $627 10%
Aetna $528 - $4,000 13%
Humana $536 - $4,000 13%
Meritain Health $546 - $665 14%
Blue Cross Blue Shield $551 - $3,264 14%
Health Alliance Plan Of Michigan $551 - $7,720 14%
Healthy Michigan Mclaren $551 - $2,092 14%
Healthy Michigan Meridian $551 - $2,092 14%
Healthy Michigan Molina $551 - $2,092 14%
Healthy Michigan Priority Health $551 - $2,092 14%
Mclaren Advantage $551 - $4,000 14%
Molina Healthplan $551 - $4,000 14%
Physicians Health Plan Advantage/Advantage Plus $551 - $4,000 14%
Multiplan $643 - $782 16%
Blue Care Network $680 - $4,000 17%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1447 N Harrison, Saginaw, MI 48602
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals