CMS Price Transparency Data

Breast lump removal

Facility: Kings County Hospital Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $1,896
  • Cash Discount Price: $4,363
  • vs. Medicare Baseline: 0.47x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Kings County Hospital Center is $1,896. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,363. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.47x the Medicare baseline. Located in 451 Clarkson Avenue, Brooklyn, NY.
Cash / Self-Pay
$4,363

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,896

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: $4,363 (109%)
Insurance Median: $1,896 (47%)
Cash: $4,363 (109% of Medicare)
Ins. Median: $1,896 (47% 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
Healthfirst $252 - $4,266 6%
Local 1199 $387 - $2,666 10%
Aetna $435 - $4,531 11%
Affinity $443 - $4,266 11%
Amidacare $503 - $1,896 13%
Blue Cross Blue Shield $503 - $4,531 13%
Centerlight $503 - $2,754 13%
Elderplan $503 - $9,063 13%
Emblem $503 - $6,797 13%
Fidelis $503 - $6,435 13%
Wellcare $511 - $3,305 13%
Centers Plan For Healthy Living $523 - $4,713 13%
Hamaspik $528 13%
Oscar $629 - $6,797 16%
Metroplus $767 - $4,266 19%
United $1,474 - $3,774 37%
Carelon $1,896 - $3,580 47%
Senior Whole Health $1,896 47%
United Behavioral Health $1,896 - $2,085 47%
Carelon (Amida Care) $1,934 48%
Vnsny $1,934 - $4,682 48%
Oxford $2,695 - $3,052 67%
Magnacare $4,131 103%
Cigna $4,285 107%
Multiplan $4,406 110%
Vaccn $4,531 113%
Villagecare Max $4,682 117%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 451 Clarkson Avenue, Brooklyn, NY 11203
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals