CMS Price Transparency Data

Breast lump removal

Facility: S E Lackey Memorial Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $2,387
Cash Discount Price: $1,107
vs. Medicare Baseline: 0.60x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at S E Lackey Memorial Hospital is $2,387. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,107. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.60x the Medicare baseline. Located in 330 N Broad Street, Forest, MS.

Cash / Self-Pay

$1,107

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,387

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: $1,107 (28%)

Insurance Median: $2,387 (60%)

Cash: $1,107 (28% of Medicare)

Ins. Median: $2,387 (60% 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
Blue Cross Blue Shield	$100 - $6,870	2%
UnitedHealthcare	$316 - $4,263	8%
Magnolia Mcr Adv	$372 - $2,387	9%
Va Ccn - All Plans	$372 - $2,387	9%
Wellcare Mcr Adv - All Plans	$372 - $2,387	9%
Cigna	$474 - $1,117	12%
Aetna	$500	12%
Corvel - All Plans	$762 - $5,116	19%
Magnolia Comm/Exch - All Other Plans	$2,387	60%
Magnolia Mcaid	$2,427 - $2,918	61%
First/Health Choice - All Plans	$4,547	114%
Health Partners - All Plans	$4,718	118%
Multiplan - All Plans	$5,116	128%

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 $1,107.
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 S E Lackey Memorial Hospital 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.