CMS Price Transparency Data

Breast lump removal

Facility: East Liverpool City Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $2,790
  • Cash Discount Price: $3,686
  • vs. Medicare Baseline: 0.70x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at East Liverpool City Hospital is $2,790. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,686. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.70x the Medicare baseline. Located in 425 West 5Th Street, East Liverpool, OH.
Cash / Self-Pay
$3,686

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,790

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: $3,686 (92%)
Insurance Median: $2,790 (70%)
Cash: $3,686 (92% of Medicare)
Ins. Median: $2,790 (70% 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
Standard Eapg Logic $1,386 35%
Amerihealth Caritas $2,790 70%
Blue Cross Blue Shield $2,790 70%
Buckeye Community Health Plan $2,790 70%
Care Source $2,790 70%
Communicare $2,790 70%
Devoted Health $2,790 70%
Employer Direct Healthcare $2,790 70%
Health America $2,790 70%
Medicaid / KanCare $2,790 70%
Medical Mutual Of Oh $2,790 70%
Medicare (plans) $2,790 70%
Molina $2,790 70%
Multiplan (Fka Private Healthcare Systems) $2,790 70%
Naphcare $2,790 70%
Paramount $2,790 70%
Perennial $2,790 70%
Provider Select $2,790 70%
Three Rivers $2,790 70%
Tricare $2,790 70%
UnitedHealthcare $2,790 70%
Valor Health Plan $2,790 70%
Worker Compensation $2,790 70%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 425 West 5Th Street, East Liverpool, OH 43920
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals