CMS Price Transparency Data

Breast lump removal

Facility: Ochsner Medical Center-Hancock

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $3,551
Cash Discount Price: $2,073
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Ochsner Medical Center-Hancock is $3,551. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,073. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.89x the Medicare baseline. Located in 149 Drinkwater Blvd, Bay Saint Louis, MS.

Cash / Self-Pay

$2,073

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,551

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: $2,073 (52%)

Insurance Median: $3,551 (89%)

Cash: $2,073 (52% of Medicare)

Ins. Median: $3,551 (89% 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
Cigna	$2,182 - $3,516	55%
Mississippi Physicians Care Network	$2,728	68%
Medicaid / KanCare	$2,824 - $2,965	71%
Zelis	$2,837	71%
Humana	$3,164 - $3,516	79%
Claritev D/B/A Multiplan/Phcs/American Life Care	$3,492	87%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$3,516	88%
Medicare (plans)	$3,516 - $3,692	88%
UnitedHealthcare	$3,516 - $5,174	88%
Aetna	$3,551 - $4,392	89%
Shared Health Mississippi	$3,692	92%
Healthcomp & Personify Health (Formerly Gilsbar)	$3,819	95%
Select Administrative Services Network	$3,819	95%
Blue Cross Blue Shield	$4,656 - $5,127	116%
Ambetter / Centene	$5,625	141%
Primewell Health Services Commercial Exchange Plan	$9,844	246%
Primewell Health Services – Commercial	$9,844	246%

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 $2,073.
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 Ochsner Medical Center-Hancock 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.