CMS Price Transparency Data

Breast lump removal

Facility: Good Samaritan Hospital Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,370
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Good Samaritan Hospital Medical Center is $4,370. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.09x the Medicare baseline. Located in 1000 Montauk Highway, West Islip, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,370

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%)
Insurance Median: $4,370 (109%)
Ins. Median: $4,370 (109% 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
Zadroga $942 24%
Brighton $1,800 - $5,269 45%
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 - $4,845 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 - $4,531 48%
Blue Cross Blue Shield $3,317 - $4,441 83%
Centivo $3,685 - $4,753 92%
Local 1199 $3,945 99%
Aetna $4,308 - $5,128 108%
Self Pay $4,364 109%
Surest $4,370 109%
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%
American Plan Administrators $4,845 121%
Amerihealth Administrators $4,845 121%
Benefit Services $4,845 121%
Ghi Cbp Ny City Employee Alternate $4,845 121%
International Benefit Administrator $4,845 121%
Ultra Benefits Inc. $4,845 121%
Wellcare Health Plan Inc $4,985 125%
Mail Handlers Benefit Plan $5,128 128%
Meritain Health $5,128 128%
Nippon Life Insurance Company Of America $5,128 128%
Salvation Army $5,128 128%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Montauk Highway, West Islip, NY 11795
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals