CMS Price Transparency Data
Breast lump removal
Facility: Morristown Medical Center
Billing Code: 19120 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 19120
- Insurance Median: $4,443
- Cash Discount Price: $5,110
- vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Morristown Medical Center is $4,443. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,110. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.11x the Medicare baseline. Located in 100 Madison Ave, Morristown, NJ.
Cash / Self-Pay
$5,110
Average discount available for prompt cash payment at this facility.
Insurance Median
$4,443
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: $5,110 (128%)
Insurance Median: $4,443 (111%)
Cash: $5,110 (128% of Medicare)
Ins. Median: $4,443 (111% 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 |
|---|---|---|
| Wtc Health Program [5273] | $849 | 21% |
| Horizon Nj Health [5021] | $3,074 | 77% |
| Champva [5354] | $4,443 | 111% |
| Sedgwick Wtc Health Program Wc [5514] | $4,443 | 111% |
| Specialty Imaging [5433] | $4,443 | 111% |
| Karen Ann Quinlan [5285] | $4,443 | 111% |
| UPMC [5455] | $4,443 | 111% |
| Generic No Fault [5017] | $4,443 | 111% |
| Cigna | $4,443 | 111% |
| Concern Non Employee [5086] | $4,443 | 111% |
| Magellan [5176] | $4,443 | 111% |
| Wellcare Health Plans Ip Splits [5475] | $4,443 | 111% |
| Claimdoc [5434] | $4,443 | 111% |
| Bollinger [5065] | $4,443 | 111% |
| Amerihealth Administrators Supplemental [5512] | $4,443 | 111% |
| The Health Plan [5451] | $4,443 | 111% |
| Medicare (plans) | $4,443 - $4,599 | 111% |
| Amerihealth Medigap [5049] | $4,443 | 111% |
| Health Net [5137] | $4,443 | 111% |
| Bankers Life & Casualty Supplemental [5058] | $4,443 | 111% |
| Generic Commercial [5015] | $4,443 | 111% |
| Claim Watcher/Homestead [5488] | $4,443 | 111% |
| Luminare Health AHS Retiree [5013] | $4,443 | 111% |
| Mutual of Omaha [5195] | $4,443 | 111% |
| Aetna | $4,443 - $6,220 | 111% |
| Ghi Emblem Health [5122] | $4,443 | 111% |
| Medicaid / KanCare | $4,443 | 111% |
| Continental Casualty [5093] | $4,443 | 111% |
| Cosmetic Surgery/Lap Band/Gastric Bypass [5289] | $4,443 | 111% |
| Chubb Health [5073] | $4,443 | 111% |
| Wellcare Health Plans [5269] | $4,443 | 111% |
| Work Med [5271] | $4,443 | 111% |
| Out of Country Insurance Plan [5215] | $4,443 | 111% |
| Fairos [5491] | $4,443 | 111% |
| VA Community Care Network [5403] | $4,443 | 111% |
| Runnells Specialized Hospital [5233] | $4,443 | 111% |
| Ambetter / Centene | $4,443 | 111% |
| Kessler Institute for Rehab [5166] | $4,443 | 111% |
| Highmark Wholecare Health Plan [5413] | $4,443 | 111% |
| Highmark Wholecare Health Plan Ip Splits [5464] | $4,443 | 111% |
| Wellcare Behavioral Health [5335] | $4,443 | 111% |
| Tricare | $4,443 | 111% |
| Blue Cross Blue Shield | $4,443 | 111% |
| Us Family Health Plan [5258] | $4,443 | 111% |
| Amerihealth Caritas Vip Care [5313] | $4,488 | 112% |
| Amerihealth Caritas Vip Care Ip Splits [5460] | $4,488 | 112% |
| Kindred Giralda Hospital [5341] | $4,888 | 122% |
| Amerihealth [5008] | $5,253 - $6,049 | 131% |
| High Point No Fault [5146] | $6,949 | 174% |
| Hanover No Fault [5129] | $6,949 | 174% |
| State Farm No Fault [5241] | $6,949 | 174% |
| Zurich No Fault [5274] | $6,949 | 174% |
| Travelers No Fault [5249] | $6,949 | 174% |
| Progressive No Fault [5229] | $6,949 | 174% |
| Allstate [5047] | $6,949 | 174% |
| Usaa No Fault [5260] | $6,949 | 174% |
| Geico No Fault [5120] | $6,949 | 174% |
| Nj Manufacturers No Fault [5203] | $6,949 | 174% |
| Esurance No Fault [5105] | $6,949 | 174% |
| Plymouth Rock Assurance No Fault [5222] | $6,949 | 174% |
| Liberty Mutual No Fault [5173] | $6,949 | 174% |
| Medlogix/Consumer Health Network Pip (Chn) [5414] | $6,949 | 174% |