CMS Price Transparency Data

Breast lump removal

Facility: St Lukes Hospital of Kansas City

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $4,743
Cash Discount Price: $20,203
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at St Lukes Hospital of Kansas City is $4,743. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,203. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.19x the Medicare baseline. Located in 4401 Wornall Road, Kansas City, MO.

Cash / Self-Pay

$20,203

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,743

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: $20,203 (505%)

Insurance Median: $4,743 (119%)

Cash: $20,203 (505% of Medicare)

Ins. Median: $4,743 (119% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicaid / KanCare	$1,235 - $7,100	31%
Cigna	$2,153 - $6,958	54%
Humana	$2,250 - $4,941	56%
Blue Cross Blue Shield	$3,169 - $7,247	79%
Commercial-Contracted [8000]	$3,435	86%
UnitedHealthcare	$3,861 - $6,266	97%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $20,203.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 19120.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Lukes Hospital of Kansas City is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 19120.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.