CMS Price Transparency Data

Breast lump removal

Facility: Alliancehealth Durant

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $7,738
  • Cash Discount Price: $7,044
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Alliancehealth Durant is $7,738. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,044. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.93x the Medicare baseline. Located in 1800 University Boulevard, Durant, OK.
Cash / Self-Pay
$7,044

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,738

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: $7,044 (176%)
Insurance Median: $7,738 (193%)
Cash: $7,044 (176% of Medicare)
Ins. Median: $7,738 (193% 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
Veterans Eval Services $472 12%
Aetna $3,526 - $44,023 88%
Humana $3,526 - $3,717 88%
Medicaid / KanCare $3,526 88%
Medicare (plans) $3,717 93%
Node Hospice Non Par Agree $3,778 94%
Node Va $3,778 94%
UnitedHealthcare $3,778 - $17,081 94%
Blue Cross Blue Shield $3,829 - $8,895 96%
Node Sterling Mcr Adv $3,829 96%
Node Us Dept Of Labor $4,722 118%
Prime Health Work Comp Ok $6,063 152%
Ok Work Comp $6,250 156%
Healthchoice $7,276 182%
Self Pay $8,218 205%
Department Of Veterans Affairs $8,514 213%
Tricare $8,514 213%
Cigna $15,789 395%
Healthcare Highways $19,546 489%
Customer Linx $35,218 880%
Phcs Savility $41,088 1027%
First Health $44,023 1101%
Healthsmart $44,610 1115%
Multiplan Complementary $46,958 1174%
Multiplan Primary $46,958 1174%
Prime Health Services $46,958 1174%
One Health Plan $49,892 1247%
Preferred Community Choice Ppo $49,892 1247%
Comprehensive Medical Care $52,827 1321%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1800 University Boulevard, Durant, OK 74702
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals