CMS Price Transparency Data

Breast lump removal

Facility: Holmes County Hospital and Clinics

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $1,508
  • Cash Discount Price: $777
  • vs. Medicare Baseline: 0.38x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Holmes County Hospital and Clinics is $1,508. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $777. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.38x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.
Cash / Self-Pay
$777

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,508

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: $777 (19%)
Insurance Median: $1,508 (38%)
Cash: $777 (19% of Medicare)
Ins. Median: $1,508 (38% 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
Cigna $1,127 28%
Tricare $1,192 30%
Humana $1,212 30%
Mpcn-Lex $1,263 32%
Medadv_Uhc-Lex $1,321 33%
Firstchoice-Lex $1,360 34%
United-Lex $1,449 36%
Ambetter / Centene $1,457 36%
Medadv_Primewell-Lex $1,457 36%
Medicare (plans) $1,457 36%
Primewell-Lex $1,457 36%
Va_Ccn-Lex $1,457 36%
United-Options-Lex $1,459 36%
Medadv_Uhcdsnp-Lex $1,501 38%
Wellcare-Lex $1,501 38%
Ppoplus $1,516 38%
Devoted_Health-Lex $1,530 38%
Firsthealth-Lex $1,554 39%
Multiplan-Lex $1,554 39%
Aetna $1,652 41%
Phcs-Lex $1,749 44%
Advhealth-Lex $1,943 49%
Blue Cross Blue Shield $1,943 49%
Magnolia-Chip-Lex $1,943 49%
Molina-Chip-Lex $1,943 49%
Molina_Exchange-Lex $1,943 49%
Ms-Can-Magnolia-Lex $1,943 49%
Ms-Can-Molina-Lex $1,943 49%
Ms-Can-Truecare-Lex $1,943 49%
Truecare-Chip-Lex $1,943 49%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 239 Bowling Green Road, Lexington, MS 39095
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - State
  • Hospital Type: Critical Access Hospitals