Breast lump removal
Facility: Poplar Bluff Regional Medical Center
Billing Code: 19120 (CPT)
- CPT Billing Code: 19120
- Insurance Median: $5,250
- Cash Discount Price: $8,213
- vs. Medicare Baseline: 1.31x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $320 - $7,822 | 8% |
| Veterans Eval Services | $471 | 12% |
| Blue Cross Blue Shield | $3,496 - $11,832 | 87% |
| Node Champva | $3,955 | 99% |
| Tricare | $3,955 | 99% |
| Medicare (plans) | $4,133 | 103% |
| Node United Behavioral Health Mcr Adv | $4,133 | 103% |
| Humana | $4,174 | 104% |
| Node Hospice Non Par Agree | $4,200 | 105% |
| Node Va | $4,200 | 105% |
| UnitedHealthcare | $4,200 - $21,041 | 105% |
| Node Ahs Mcr Adv | $4,298 | 107% |
| Node Devoted Health Mcr Adv | $4,340 | 108% |
| Node Pphp Mcr Adv | $4,753 | 119% |
| Centurion Correctional | $5,250 | 131% |
| Us Department Of Labor | $5,250 | 131% |
| Naphcare | $7,980 | 199% |
| Self Pay | $9,386 | 235% |
| Home State Exchange | $10,500 | 262% |
| W W Wood | $10,500 | 262% |
| Blue Access | $13,840 | 346% |
| Cigna | $21,198 - $31,288 | 530% |
| Evolutions Healthcare | $21,315 | 533% |
| Tyson Foods | $21,511 | 538% |
| Access Health Services, Llc | $22,293 | 557% |
| First Health | $23,466 | 587% |
| Healthlink | $24,444 | 611% |
| Parker Hannifin | $27,377 | 684% |
| Blue Traditional | $28,926 | 723% |
| Coventry Wc | $31,288 | 782% |
| Municipal Health | $31,288 | 782% |
| Multiplan | $34,026 | 851% |
| Phcs | $34,026 | 851% |
| Compresults Wc | $35,199 | 880% |