CMS Price Transparency Data

Breast lump removal

Facility: North Vista Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,259
  • Cash Discount Price: $4,258
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at North Vista Hospital is $4,259. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,258. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.06x the Medicare baseline. Located in 1409 East Lake Mead Blvd, North Las Vegas, NV.
Cash / Self-Pay
$4,258

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,259

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: $4,258 (106%)
Insurance Median: $4,259 (106%)
Cash: $4,258 (106% of Medicare)
Ins. Median: $4,259 (106% 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
Medicaid / KanCare $957 - $967 24%
Blue Cross Blue Shield $967 - $11,737 24%
Molina Healthcare $967 - $4,259 24%
Silver Summit $967 - $6,814 24%
Sierra Health $1,226 31%
Aetna $1,375 - $4,259 34%
Three Rivers $1,725 43%
Provider Select $1,760 44%
Worker Comp $1,778 44%
UnitedHealthcare $2,191 - $2,331 55%
Triwest $4,216 105%
Intermountain Healthcare (Hcp) $4,259 - $7,666 106%
Medicare (plans) $4,259 106%
Renal Payor Solutions $4,259 106%
Tricare $4,259 106%
Alignment $4,344 109%
Employer Direct Healthcare $5,962 149%
Imperial Insurance Companies $6,388 - $7,879 160%
Naphcare $6,601 165%
Health Services Coalition $8,092 202%
Nevada Health Partners $8,144 204%
6 Degrees Health $8,518 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1409 East Lake Mead Blvd, North Las Vegas, NV 89030
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals