CMS Price Transparency Data

Breast lump removal

Facility: Mid-Columbia Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $504
Cash Discount Price: $801
vs. Medicare Baseline: 0.13x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Mid-Columbia Medical Center is $504. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $801. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.13x the Medicare baseline. Located in 1700 E 19Th Street, The Dalles, OR.

Cash / Self-Pay

$801

Average discount available for prompt cash payment at this facility.

Insurance Median

$504

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: $801 (20%)

Insurance Median: $504 (13%)

Cash: $801 (20% of Medicare)

Ins. Median: $504 (13% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$393 - $829	10%
Community Hp Mcr Adv - All Plans	$393	10%
Molina Mcr Adv	$393	10%
Tricare	$393	10%
Va Ccn Triwest - All Plans	$393	10%
Healthnet Mcr Adv	$401	10%
Humana	$405	10%
Moda Mcr Adv	$405	10%
Devoted Mcr Adv - All Plans	$424	11%
Employee Health Plan - All Plans	$432	11%
Molina - All Other Plans	$432	11%
Healthnet - All Other Plans	$576	14%
Cigna	$658	16%
Multiplan/Phcs - All Plans	$668	17%
Coventry - All Plans	$744	19%
Aetna	$746	19%
First Choice - All Plans	$756	19%
Providence Ppo - All Plans	$792	20%
Moda Health Plan - All Other Plans	$830	21%
Molina Mcaid	$867	22%
Amerigroup Mcaid - All Plans	$1,668	42%
Coordinated Care Mcaid - All Plans	$1,668	42%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $801.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 19120.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mid-Columbia Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 19120.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.