CMS Price Transparency Data

Breast lump removal

Facility: Mary Lanning Healthcare

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $559
Cash Discount Price: $1,354
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Mary Lanning Healthcare is $559. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,354. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.14x the Medicare baseline. Located in 715 N St Joseph Ave, Hastings, NE.

Cash / Self-Pay

$1,354

Average discount available for prompt cash payment at this facility.

Insurance Median

$559

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: $1,354 (34%)

Insurance Median: $559 (14%)

Cash: $1,354 (34% of Medicare)

Ins. Median: $559 (14% 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
Tricare	$343	9%
Aetna	$365 - $374	9%
Blue Cross Blue Shield	$365 - $700	9%
Medica Mcr Adv	$365	9%
Ne Total Care Mcr Adv	$365	9%
UnitedHealthcare	$365 - $552	9%
Va Ccn - All Plans	$365	9%
Consociate Inc-All Plans	$566	14%
Ambetter / Centene	$602	15%
Medica-All Other Plans	$639	16%
Nhn/Mna-All Plans	$693	17%
Midlands Choice-All Plans	$883	22%
Workers Compensation-All Plans	$1,086	27%
Multiplan-All Plans	$1,354	34%
Provider Network Of America-All Plans	$1,354	34%

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 $1,354.
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 Mary Lanning Healthcare 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.