CMS Price Transparency Data

Breast lump removal

Facility: Hillsboro Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,548
  • Cash Discount Price: $9,352
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Hillsboro Medical Center is $4,548. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,352. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.14x the Medicare baseline. Located in 335 Se 8Th Avenue, Hillsboro, OR.
Cash / Self-Pay
$9,352

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,548

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: $9,352 (234%)
Insurance Median: $4,548 (114%)
Cash: $9,352 (234% of Medicare)
Ins. Median: $4,548 (114% 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
Care Oregon $1,741 - $5,135 44%
Health Net Health Plan Of Oregon, Inc. $1,741 - $9,496 44%
Medicare (plans) $1,741 - $5,135 44%
UnitedHealthcare $1,741 - $14,388 44%
Intercommunity Health Network $3,395 85%
Kaiser Foundation Hospitals $3,482 - $12,752 87%
Pacific Source $3,482 - $9,208 87%
Community Health Plan Of Washington $4,352 - $14,388 109%
Providence Health Plan $4,352 - $9,352 109%
Samaritan Health Plan $4,352 109%
Trillium $4,352 109%
Humana $4,483 - $4,613 112%
Aetna $4,700 - $12,949 117%
Moda $4,787 - $14,388 120%
Tuality Health $7,834 196%
Cigna $9,928 248%
Blue Cross Blue Shield $11,132 278%
First Choice $11,510 288%
Coventry First Health $12,230 306%
Molina Exchange $14,388 360%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 335 Se 8Th Avenue, Hillsboro, OR 97123
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals