Breast lump removal
Facility: St Francis Hospital - the Heart Center
Billing Code: 19120 (CPT)
- CPT Billing Code: 19120
- Insurance Median: $4,531
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.13x 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 |
|---|---|---|
| Zadroga | $942 | 24% |
| Affinity Health Plan | $1,919 - $4,318 | 48% |
| Centerlight Healthcare | $1,919 - $4,531 | 48% |
| Elderplan Inc. | $1,919 - $4,531 | 48% |
| Emblem Health | $1,919 - $5,383 | 48% |
| Fidelis Care New York | $1,919 - $4,531 | 48% |
| Health First | $1,919 - $10,196 | 48% |
| Health Plus | $1,919 - $4,531 | 48% |
| Independent Health | $1,919 - $4,531 | 48% |
| Medicaid / KanCare | $1,919 | 48% |
| Mvp Health Plans | $1,919 - $4,753 | 48% |
| Senior Whole Health | $1,919 - $4,531 | 48% |
| UnitedHealthcare | $1,919 - $6,542 | 48% |
| Brighton | $1,950 - $5,879 | 49% |
| Centivo | $3,913 - $4,753 | 98% |
| Local 1199 | $3,945 | 99% |
| Blue Cross Blue Shield | $4,441 - $6,542 | 111% |
| Aetna | $4,531 - $5,445 | 113% |
| Centers Plan For Healthy Living | $4,531 | 113% |
| Healthspring | $4,531 | 113% |
| Liberty Health | $4,531 | 113% |
| Longevity Health Plan | $4,531 | 113% |
| Medicare (plans) | $4,531 - $4,758 | 113% |
| Orthonet - Uniformed Services Family Health Plan | $4,531 | 113% |
| Pmc | $4,531 | 113% |
| Tricare | $4,531 | 113% |
| Universal Healthcare | $4,531 | 113% |
| Us Family Health Plan | $4,531 | 113% |
| Veterans Affairs | $4,531 | 113% |
| Humana | $4,622 | 116% |
| Agewell New York | $4,690 | 117% |
| Apwu | $4,753 | 119% |
| Cigna | $4,753 | 119% |
| Daniel H Cook | $4,753 | 119% |
| Nalc | $4,753 | 119% |
| Samba | $4,753 | 119% |
| Partners Health Plan | $4,758 | 119% |
| Wellcare Health Plan Inc | $4,985 | 125% |
| American Plan Administrators | $5,383 | 135% |
| Amerihealth Administrators | $5,383 | 135% |
| Benefit Services | $5,383 | 135% |
| Ghi Cbp Ny City Employee Alternate | $5,383 | 135% |
| International Benefit Administrator | $5,383 | 135% |
| Ultra Benefits Inc. | $5,383 | 135% |
| Mail Handlers Benefit Plan | $5,445 | 136% |
| Meritain Health | $5,445 | 136% |
| Nippon Life Insurance Company Of America | $5,445 | 136% |
| Salvation Army | $5,445 | 136% |
| Surest | $5,453 | 136% |
| Self Pay | $6,542 | 164% |