CMS Price Transparency Data

Breast lump removal

Facility: Long Island Community Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,857
  • Cash Discount Price: $1,008
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Long Island Community Hospital is $4,857. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,008. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.21x the Medicare baseline. Located in 101 Hospital Road, Patchogue, NY.
Cash / Self-Pay
$1,008

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,857

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: $1,008 (25%)
Insurance Median: $4,857 (121%)
Cash: $1,008 (25% of Medicare)
Ins. Median: $4,857 (121% 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
Local 1199 $1,816 45%
Magellan $2,361 59%
Multiplan $2,361 59%
Oscar Health Exchange $2,470 62%
Coventry $2,688 67%
Longevity Health $2,905 73%
Galaxy $3,269 82%
Aarp $3,632 91%
Aetna $3,632 - $8,201 91%
Beacon Health Options $3,632 91%
Blue Cross Blue Shield $3,632 - $10,963 91%
Centerlight $3,632 91%
Cigna $3,632 - $17,639 91%
Emblem Ghi $3,632 91%
Fidelis $3,632 91%
Humana $3,632 91%
Integra $3,632 91%
Medicare (plans) $3,632 91%
UnitedHealthcare $3,632 - $5,699 91%
Agewell $3,759 94%
Emblem $3,941 99%
Elderplan Inc. $3,995 100%
Wellcare $3,995 100%
Nexus Nyu $5,035 126%
Empire Mediblue $7,751 - $10,963 194%
Magnacare $7,751 - $25,488 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 Hospital Road, Patchogue, NY 11772
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals