CMS Price Transparency Data

Breast lump removal

Facility: Garden City Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,884
  • Cash Discount Price: $3,883
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Garden City Hospital is $3,884. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,883. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.97x the Medicare baseline. Located in 6245 Inkster Rd, Garden City, MI.
Cash / Self-Pay
$3,883

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,884

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: $3,883 (97%)
Insurance Median: $3,884 (97%)
Cash: $3,883 (97% of Medicare)
Ins. Median: $3,884 (97% 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
Barbara $423 11%
Aetna $2,082 - $3,884 52%
Beacon Health Strategies $2,082 52%
Harbor Health Plan $2,082 - $3,884 52%
Mclaren Health Plan $2,082 - $3,884 52%
Medicaid / KanCare $2,082 - $2,290 52%
Priority Health $2,082 52%
Total Health Care Priority Health $2,082 - $3,884 52%
Blue Cross Blue Shield $3,352 - $3,884 84%
Honest Hmo $3,884 97%
Humana $3,884 97%
Medicare (plans) $3,884 97%
Sunrise $3,884 97%
Tricare $3,884 97%
UnitedHealthcare $3,884 97%
Zing $4,078 102%
Longevity Hp $4,117 103%
Employer Direct Healthcare $5,437 136%
Naphcare Residential Inmate Treatment Center $6,020 150%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6245 Inkster Rd, Garden City, MI 48135
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals