CMS Price Transparency Data

Breast lump removal

Facility: Hackensack University Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $5,787
Cash Discount Price: $4,510
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Hackensack University Medical Center is $5,787. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,510. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.45x the Medicare baseline. Located in 30 Prospect Ave, Hackensack, NJ.

Cash / Self-Pay

$4,510

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,787

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: $4,510 (113%)

Insurance Median: $5,787 (145%)

Cash: $4,510 (113% of Medicare)

Ins. Median: $5,787 (145% 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
Karna	$902	23%
Clover	$1,263	32%
UnitedHealthcare	$1,543 - $11,528	39%
Aetna	$1,761 - $7,773	44%
Seoul Medical Group	$2,006	50%
Horizon	$2,728 - $16,802	68%
Lhp Health	$3,548	89%
Blue Cross Blue Shield	$4,510	113%
Vaccn	$4,510	113%
Wellcare	$4,510	113%
United Community/Americhoice	$4,735	118%
Intergroup	$4,910	123%
Bergen Risk	$5,260	131%
Cigna	$5,611 - $6,379	140%
Activecare First McO	$5,962	149%
Chn	$5,962	149%
Multiplan - PHCS	$5,962	149%
Qualcare	$6,242 - $7,712	156%
Brighton Health Plan	$6,313	158%
Amerihealth	$8,013 - $8,904	200%
Oxford	$9,571	239%

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 $4,510.
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 Hackensack University Medical Center 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.