CMS Price Transparency Data

Breast lump removal

Facility: Akron General Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $1,426
  • Cash Discount Price: $3,243
  • vs. Medicare Baseline: 0.36x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Akron General Medical Center is $1,426. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,243. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.36x the Medicare baseline. Located in 1 Akron General Avenue, Akron, OH.
Cash / Self-Pay
$3,243

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,426

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: $3,243 (81%)
Insurance Median: $1,426 (36%)
Cash: $3,243 (81% of Medicare)
Ins. Median: $1,426 (36% 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
Oscar $175 - $3,016 4%
UnitedHealthcare $204 - $4,864 5%
Buckeye $215 - $855 5%
Caresource $226 - $855 6%
United $226 - $3,538 6%
Amerihealth $237 - $941 6%
Molina $237 - $898 6%
Ohcp $256 - $3,813 6%
Summacare $259 - $3,538 6%
Omas $328 - $3,922 8%
Phphi $394 - $4,707 10%
Aetna $399 - $7,845 10%
Blue Cross Blue Shield $399 - $9,063 10%
Humana $399 - $3,538 10%
The Health Plan $399 - $5,413 10%
Valor $399 - $3,538 10%
Communicare $419 10%
Pphp $431 - $3,892 11%
Zing Health $439 - $3,892 11%
Gms $460 - $5,492 11%
Mmo $460 - $4,002 11%
Consociate Health $493 - $5,884 12%
Aultcare $522 - $4,315 13%
Cigna $569 - $6,276 14%
Multiplan $591 - $7,060 15%
United Bh $906 23%
Cc Ehp $3,130 - $3,177 78%
Upmc $3,296 - $4,707 82%
Amish Community Aid Plan $3,530 - $3,922 88%
Perennial Health $3,821 96%
Ohio Healthy $4,236 106%
Php $4,707 118%
Medical Benefit Corp $5,492 137%
Frontpath $7,060 176%
Managed Care Services $7,060 176%
Tertiary Care Network $7,060 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Akron General Avenue, Akron, OH 44307
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals