Breast lump removal
Facility: AHS Hospital Corp
Billing Code: 19120 (CPT)
- CPT Billing Code: 19120
- Insurance Median: $4,443
- Cash Discount Price: $5,110
- vs. Medicare Baseline: 1.11x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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% |
| Amerihealth [5008] | $3,936 - $4,841 | 98% |
| Specialty Imaging [5433] | $4,184 | 105% |
| Fairos [5491] | $4,184 | 105% |
| Karen Ann Quinlan [5285] | $4,184 | 105% |
| Cosmetic Surgery/Lap Band/Gastric Bypass [5289] | $4,184 | 105% |
| Medicaid / KanCare | $4,184 | 105% |
| Horizon Nj Health [5021] | $4,300 | 107% |
| Amerihealth Administrators Supplemental [5512] | $4,443 | 111% |
| Cigna | $4,443 | 111% |
| Us Family Health Plan [5258] | $4,443 | 111% |
| Wellcare Behavioral Health [5335] | $4,443 | 111% |
| Aetna | $4,443 - $6,220 | 111% |
| Ambetter / Centene | $4,443 | 111% |
| Highmark Wholecare Health Plan Ip Splits [5464] | $4,443 | 111% |
| Claimdoc [5434] | $4,443 | 111% |
| Luminare Health AHS Retiree [5013] | $4,443 | 111% |
| VA Community Care Network [5403] | $4,443 | 111% |
| Tricare | $4,443 | 111% |
| Champva [5354] | $4,443 | 111% |
| Blue Cross Blue Shield | $4,443 | 111% |
| Sedgwick Wtc Health Program Wc [5514] | $4,443 | 111% |
| UPMC [5455] | $4,443 | 111% |
| Amerihealth Medigap [5049] | $4,443 | 111% |
| Wellcare Health Plans Ip Splits [5475] | $4,443 | 111% |
| Highmark Wholecare Health Plan [5413] | $4,443 | 111% |
| Medicare (plans) | $4,443 - $4,599 | 111% |
| Wellcare Health Plans [5269] | $4,443 | 111% |
| Claim Watcher/Homestead [5488] | $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% |
| Nj Manufacturers No Fault [5203] | $6,949 | 174% |
| Esurance No Fault [5105] | $6,949 | 174% |
| Liberty Mutual No Fault [5173] | $6,949 | 174% |
| Plymouth Rock Assurance No Fault [5222] | $6,949 | 174% |
| Progressive No Fault [5229] | $6,949 | 174% |
| High Point No Fault [5146] | $6,949 | 174% |
| Hanover No Fault [5129] | $6,949 | 174% |
| Geico No Fault [5120] | $6,949 | 174% |
| State Farm No Fault [5241] | $6,949 | 174% |
| Travelers No Fault [5249] | $6,949 | 174% |
| Allstate [5047] | $6,949 | 174% |
| Usaa No Fault [5260] | $6,949 | 174% |
| Zurich No Fault [5274] | $6,949 | 174% |
| Medlogix/Consumer Health Network Pip (Chn) [5414] | $6,949 | 174% |