CMS Price Transparency Data

Breast lump removal

Facility: Akron Children's Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $482
  • Cash Discount Price: $585
  • vs. Medicare Baseline: 0.12x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Akron Children's Hospital is $482. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $585. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.12x the Medicare baseline. Located in 1 Perkins Square, Akron, OH.
Cash / Self-Pay
$585

Average discount available for prompt cash payment at this facility.

Insurance Median
$482

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: $585 (15%)
Insurance Median: $482 (12%)
Cash: $585 (15% of Medicare)
Ins. Median: $482 (12% 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
Healthplan (Hometown) $141 4%
Summacare $141 - $945 4%
Northern Ohio Handicapped Fund (Nohf $149 4%
Ohio Crippled Childrens Fund (Occf $149 4%
Amish Church Fund $207 5%
Aetna $222 - $1,433 6%
Blue Cross Blue Shield $226 - $1,433 6%
Buckeye Community Health Plan $226 - $1,433 6%
Caresource $226 - $1,406 6%
Molina $226 - $1,433 6%
Humana $228 - $1,447 6%
UnitedHealthcare $228 - $1,474 6%
Amerihealth Caritas Ohio $232 - $1,474 6%
Medben $315 8%
Mmo $320 - $1,088 8%
Summa Health Employee $323 8%
Summacare Preferred Choice Network $326 8%
Autlcare $327 - $732 8%
The Health Plan (Mountaineer Region) $333 8%
Avita-Osu Health Plan $339 8%
The Health Plan (Fna Hometown Health Network) $348 9%
Cigna $352 - $998 9%
Healthsmart (Fna Emerald Health Network) $362 9%
Embs/Thomas Steel $364 9%
Ohio Health Choice $364 9%
Phcs/Multiplan $364 9%
Enterprise Group Planning $373 9%
Prime Health Services $373 9%
Primenet $373 9%
Quality Care Partners $373 9%
Beechstreet $385 10%
Ohio Preferred Network $385 10%
Paramount $385 10%
Cofinity $389 10%
Health Reach Ohio Health Group $389 10%
Direct Care America $393 10%
First Health Network $393 10%
Cenpatico $1,433 36%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Perkins Square, Akron, OH 44308
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens