CMS Price Transparency Data

Breast lump removal

Facility: NYU Langone Hospitals

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $6,045
  • Cash Discount Price: $1,473
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at NYU Langone Hospitals is $6,045. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,473. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.51x the Medicare baseline. Located in 550 First Avenue, New York, NY.
Cash / Self-Pay
$1,473

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,045

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: $1,473 (37%)
Insurance Median: $6,045 (151%)
Cash: $1,473 (37% of Medicare)
Ins. Median: $6,045 (151% 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 $1,204 - $4,724 30%
Amida $2,100 52%
Fidelis $2,100 - $4,724 52%
Healthplus $2,100 - $4,724 52%
Hip $2,100 - $15,522 52%
Medicaid / KanCare $2,100 52%
Metroplus $2,100 - $8,972 52%
UnitedHealthcare $2,100 - $19,583 52%
Somos $2,205 - $2,834 55%
Ghi $4,531 - $21,938 113%
Medicare (plans) $4,531 113%
Wellcare $4,531 113%
Centerlight $4,622 116%
Oscar $4,936 123%
1199 $6,022 - $7,084 151%
Multiplan $6,045 151%
Aetna $7,751 - $16,512 194%
Hamaspik $9,062 - $15,501 227%
Oxford $10,583 - $17,299 265%
Blue Cross Blue Shield $10,869 - $13,586 272%
Magnacare $13,453 - $27,119 336%
Cigna $18,962 474%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 550 First Avenue, New York, NY 10016
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals