CMS Price Transparency Data

Breast lump removal

Facility: Atrium Health Lincoln

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,781
  • Cash Discount Price: $4,632
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Atrium Health Lincoln is $3,781. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,632. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.95x the Medicare baseline. Located in 433 McAlister Rd, Lincolnton, NC.
Cash / Self-Pay
$4,632

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,781

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: $4,632 (116%)
Insurance Median: $3,781 (95%)
Cash: $4,632 (116% of Medicare)
Ins. Median: $3,781 (95% 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
Trillium $284 - $1,096 7%
Amerihealth Caritas $287 - $1,045 7%
Carolina Complete Health $287 - $1,064 7%
Healthy Blue $287 - $1,064 7%
Partners $287 - $1,075 7%
UnitedHealthcare $287 - $5,280 7%
Vaya $287 - $1,075 7%
Wellcare $287 - $1,064 7%
Alliance $290 - $1,086 7%
Cigna $384 - $6,253 10%
Humana $392 - $3,664 10%
Aetna $397 - $7,874 10%
Orthocarolina $480 - $4,490 12%
Blue Cross Blue Shield $982 - $4,712 25%
Ambetter / Centene $3,030 - $3,446 76%
Employers Health Network $4,094 102%
Medcost $4,363 - $6,058 109%
Physician Reach Out $4,632 116%
Gmmi $6,021 151%
Quik Trip $6,021 151%
Choicecare $7,596 190%
First Health $7,874 197%
Beechstreet $8,337 208%
Private Health Care Systems $8,337 208%
Multiplan $8,800 220%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 433 McAlister Rd, Lincolnton, NC 28092
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals