CMS Price Transparency Data

Breast lump removal

Facility: Flushing Hospital Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,864
  • Cash Discount Price: $2,052
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Flushing Hospital Medical Center is $4,864. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,052. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.22x the Medicare baseline. Located in 45Th Avenue and Parsons Boulevard, Flushing, NY.
Cash / Self-Pay
$2,052

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,864

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: $2,052 (51%)
Insurance Median: $4,864 (122%)
Cash: $2,052 (51% of Medicare)
Ins. Median: $4,864 (122% 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
1199 National Benefit Fund $578 - $4,001 14%
Hotel Trades Council $1,912 48%
Empire Blue Priority $2,734 68%
Empire $3,217 - $4,864 80%
Aetna $3,754 - $4,864 94%
Oscar $4,018 100%
Healthfirst $4,134 103%
UnitedHealthcare $4,215 - $4,864 105%
Cigna $4,250 106%
Create Health Plan $4,338 108%
Magnacare $4,555 - $5,593 114%
Fidelis $4,620 - $4,864 115%
Centivo $4,679 117%
Beacon Health Strategies $4,864 122%
Centerlight Healthcare $4,864 122%
Ghi $4,864 122%
Hip $4,864 - $5,159 122%
Metroplus $4,864 - $5,350 122%
Humana $4,912 - $5,155 123%
Elderplan $4,961 124%
Vns $4,961 124%
Wellcare Of Ny $5,058 126%
Villagecaremax $5,107 128%
Senior Whole Health $5,155 129%
Elderserve Health $5,593 140%
Hamaspik Choice $5,593 140%
Centers Plan For Healthy Living $5,836 146%
Emblemhealth $7,587 190%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 45Th Avenue and Parsons Boulevard, Flushing, NY 11355
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals