CMS Price Transparency Data

Breast lump removal

Facility: Munson Healthcare Cadillac Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $1,065
  • Cash Discount Price: $1,160
  • vs. Medicare Baseline: 0.27x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Munson Healthcare Cadillac Hospital is $1,065. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,160. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.27x the Medicare baseline. Located in 400 Hobart St, Cadillac, MI.
Cash / Self-Pay
$1,160

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,065

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: $1,160 (29%)
Insurance Median: $1,065 (27%)
Cash: $1,160 (29% of Medicare)
Ins. Median: $1,065 (27% 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 - $2,970 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%
American Health Associates $400 - $3,901 10%
Autumnwood Of Mcbain Skilled Nursing $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%
Michigan Amish Medical Board $400 - $3,901 10%
Promedica $400 - $3,901 10%
Samaritas Senior Living Skilled Nursing $400 - $3,901 10%
Wellcare (Meridian) $400 - $3,901 10%
Aetna $545 - $3,901 14%
Cofinity $545 - $1,065 14%
Provider Network Of America Group Health $559 - $1,160 14%
Cigna $582 - $1,632 15%
Asr/Physicians Care $599 - $1,092 15%
Employee Benefits Logistics $679 - $6,632 17%
Hospice Of Michigan $819 20%
Munson Hospice $852 - $956 21%
Enterprise Group Planning/Employee Benefit Plan $1,092 27%
Medical Cost Savings Solution $1,092 27%
Nomi Health $1,092 27%
Robbing Group And Regency Employee Benefits $1,092 27%
First Health/Coventry Network $1,160 29%
Three Rivers Provider Network $1,160 29%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 Hobart St, Cadillac, MI 49601
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals