CMS Price Transparency Data

Breast lump removal

Facility: Incline Village Community Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $1,669
Cash Discount Price: $1,854
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Incline Village Community Hospital is $1,669. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,854. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.42x the Medicare baseline. Located in 880 Alder Street, Incline Village, NV.

Cash / Self-Pay

$1,854

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,669

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: $1,854 (46%)

Insurance Median: $1,669 (42%)

Cash: $1,854 (46% of Medicare)

Ins. Median: $1,669 (42% 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
Medicare (plans)	$158 - $400	4%
Blue Cross Blue Shield	$214 - $1,837	5%
Aetna	$357 - $1,796	9%
Prominence Healthfirst - All Plans	$357 - $1,796	9%
Admar Multiplan - All Plans	$365 - $1,837	9%
First Health - All Plans	$365 - $1,837	9%
Great West/One Health - All Plans	$365 - $1,837	9%
Hometown Hp - All Plans	$365 - $1,837	9%
Humana	$365 - $1,837	9%
Interplan - All Plans	$365 - $1,837	9%
Multiplan - All Plans	$365 - $1,837	9%
Phcs - All Plans	$365 - $1,837	9%
UnitedHealthcare	$365 - $573	9%
Cigna	$374 - $1,878	9%
Beech Street/Capp Care - All Plans	$386 - $1,939	10%
Healthnet - All Plans	$386 - $540	10%
Uhn - All Plans	$386 - $1,939	10%
Sierra Health - All Plans	$394 - $1,980	10%
Ca Hlth And Wellness - All Plans	$414 - $440	10%

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 $1,854.
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 Incline Village Community Hospital 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.