CMS Price Transparency Data

Breast lump removal

Facility: Holland Community Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $632
  • Cash Discount Price: $247
  • vs. Medicare Baseline: 0.16x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Holland Community Hospital is $632. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.16x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.
Cash / Self-Pay
$247

Average discount available for prompt cash payment at this facility.

Insurance Median
$632

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: $247 (6%)
Insurance Median: $632 (16%)
Cash: $247 (6% of Medicare)
Ins. Median: $632 (16% 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
Nomi Health - All Plans $84 - $632 2%
Molina Mcaid - All Plans $116 - $1,603 3%
Ph Mcaid $116 - $1,603 3%
Aetna $253 - $4,018 6%
Cofinity -All Plans $253 - $731 6%
Multiplan - All Plans $314 - $696 8%
Benefit Source Inc-All Plans $325 - $618 8%
First Health-All Plans $325 - $519 8%
Usa Managed Care-All Plans $325 8%
Integrated Health Plans-All Plans $343 9%
UnitedHealthcare $361 - $1,603 9%
Life Circles-All Plans $380 - $3,706 9%
Health Alliance Mcr Adv $400 - $3,901 10%
Ph Mcr Adv $400 - $3,901 10%
Va Ccn - All Plans $400 - $3,901 10%
Longevity Health Plan-All Plans $432 - $4,213 11%
Cigna $515 - $3,171 13%
Priority Health - All Other Plans $582 - $3,512 15%
Blue Cross Blue Shield $680 17%
Sisco-All Other Plans $762 - $6,578 19%
Blue Care Network - All Plans $786 20%
Asr - All Plans $918 - $9,242 23%
Health Alliance Ahl - All Other Plans $918 - $9,242 23%
Health Alliance Hmo $918 - $8,840 23%
Meridian Mcaid Profee Only-All Plans $1,603 40%
Sisco Epi $6,578 164%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 602 Michigan Ave, Holland, MI 49423
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals