CMS Price Transparency Data

Breast lump removal

Facility: Saint Alphonsus Medical Center Ontario

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $442
  • Cash Discount Price: $1,470
  • vs. Medicare Baseline: 0.11x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Saint Alphonsus Medical Center Ontario is $442. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,470. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.11x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$1,470

Average discount available for prompt cash payment at this facility.

Insurance Median
$442

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: $1,470 (37%)
Insurance Median: $442 (11%)
Cash: $1,470 (37% of Medicare)
Ins. Median: $442 (11% 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

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $130 - $615 3%
Oregon Screenwise $164 - $205 4%
Aetna $192 - $1,012 5%
Align Senior Care $192 - $410 5%
Ally Align Care Adv $192 - $410 5%
American Health Plan $192 - $410 5%
Aurora Special Needs $192 - $410 5%
Blue Care Network Advantage $192 - $410 5%
Blue Cross Blue Shield $192 - $796 5%
Blue Shield - De (Highmark) Medciare Advantage $192 - $410 5%
Care Dimensions $192 - $410 5%
Care Improvement Plus $192 - $410 5%
Care Resources Pace $192 - $410 5%
Careplus Health Plans $192 - $410 5%
Cca - Zing Health $192 - $410 5%
Cca Senior Care Options $192 - $410 5%
Central Valley Medical Services Corp Pace $192 - $410 5%
Champion Health Plan Mcr Advantage $192 - $410 5%
Cigna $192 - $637 5%
Clear Spring Health $192 - $410 5%
Clover Health $192 - $410 5%
Commonwealth Care Alliance $192 - $410 5%
Community Pace At Home $192 - $410 5%
Eddy Senior Care-Pace $192 - $410 5%
Eddy Seniorcare Pace $192 - $410 5%
Elementcare $192 - $410 5%
Evercare $192 - $410 5%
Everence $192 - $410 5%
Gateway Health Plan $192 - $410 5%
Genesys Pace Of Genesee County $192 - $410 5%
Georgia Health Advantage $192 - $410 5%
Gold Advantage $192 - $410 5%
Gpa Croell Redi Mix $192 - $410 5%
Health America Advantra $192 - $410 5%
Highmark Health Options Dual Plan $192 - $410 5%
Hope Select Pace $192 - $410 5%
Horizon Nj Total Care $192 - $410 5%
Hudson Headwaters Pace $192 - $410 5%
Humana $192 - $1,362 5%
Huron Valley Pace $192 - $410 5%
Innovative Integrated Health Community Plans $192 - $410 5%
Iowa Health Advantage $192 - $410 5%
Johns Hopkins Advantage Md $192 - $410 5%
Lasso Healthcare Msa $192 - $410 5%
Life St Marys Pace $192 - $410 5%
Lifecircles Pace $192 - $410 5%
Longevity Health Plan $192 - $410 5%
Longevity Ipa Of Michigan Llc Health Plan Isnp $192 - $410 5%
Martins Point Generations Advantage $192 - $410 5%
Mass General Brigham Mcr Adv $192 - $410 5%
Medicare (plans) $192 - $460 5%
Medipak Advantage $192 - $410 5%
Mercy Life $192 - $410 5%
Mercyone Cedar Valley $192 - $410 5%
Meridian Complete $192 - $410 5%
Michigan Complete Health $192 - $410 5%
Nascentia Health Plus $192 - $410 5%
New Centry Health Careplus $192 - $410 5%
Osu Prime Care Advantage $192 - $410 5%
Pace Cny $192 - $410 5%
Pace Iowa Immanuel Pathways $192 - $410 5%
Pace Of Southwest Michigan $192 - $615 5%
Pace Southeast $192 - $410 5%
Pace-Trinity Health $192 - $410 5%
Peak Pace Solutions $192 - $410 5%
Perennial Advantage $192 - $410 5%
Preferred Care Partners $192 - $410 5%
Presbyterian Senior Plan $192 - $410 5%
Provider Partners Health Plan Of Illinois $192 - $410 5%
Provider Partners Health Plan Of Indiana $192 - $410 5%
Pruitthealth Premier $192 - $410 5%
Reliance Community Care Partners Care Resources Pace $192 - $410 5%
Rx Allwin $192 - $410 5%
Rx Grane Grnmedd $192 - $410 5%
Rx Retiree Rx Care $192 - $410 5%
Scan Health Plan Mcr Ipa Meritage Oon $192 - $410 5%
Secure Horizons Ma Pffs $192 - $410 5%
Serenity Pace $192 - $410 5%
Siouxland Pace $192 - $410 5%
Solis Health Plans $192 - $410 5%
Sunnyview-Pace Finance Dept $192 - $410 5%
Texan Plus $192 - $410 5%
The Health Plan $192 - $410 5%
Thome Pace $192 - $410 5%
Todays Options $192 - $410 5%
Tribute Health Plans $192 - $410 5%
Um Health Advantage $192 - $410 5%
Union Health Service $192 - $410 5%
UnitedHealthcare $192 - $806 5%
Welbe Health $192 - $410 5%
Wellmed $192 - $410 5%
Veterans Administration $196 - $418 5%
Champva $197 - $367 5%
Tricare $197 - $367 5%
Triwest Health Alliance $197 - $367 5%
Us Family Health Plan $197 - $367 5%
Veterans Eval Services $197 - $367 5%
American Health Advantage Of Idaho $200 - $431 5%
Albany County Correctional Facility $205 - $615 5%
Ambetter / Centene $205 - $615 5%
Amish Mennonite $205 - $615 5%
Ascension St. Vincent Public Safety Medical $205 - $615 5%
Bcccp-Michigan $205 - $615 5%
Bccp $205 - $615 5%
Bmc Healthnet $205 - $615 5%
Breast Grant-Connecticut $205 - $615 5%
Broward County Dept Of Health $205 - $615 5%
California Health And Wellness $205 - $615 5%
Can Community Health Inc $205 - $615 5%
Cardinal Innovations Lme $205 - $615 5%
Care Connections Of Northern Iowa $205 - $615 5%
Care Oregon Ohp $205 - $615 5%
Cencal Health Plan $205 - $615 5%
Cenpatico $205 - $615 5%
Chhuny $205 - $615 5%
Childrens Comm Health Plan $205 - $615 5%
Childrens Medical Services Title 19 $205 - $615 5%
City Of Philadelphia $205 - $615 5%
Cmh Allegan County $205 - $615 5%
Cmh Ausable Valley $205 - $615 5%
Cmh Barry County $205 - $615 5%
Cmh Bay-Arenac County $205 - $615 5%
Cmh Berrien County $205 - $615 5%
Cmh Cass County $205 - $615 5%
Cmh Central Mi County $205 - $615 5%
Cmh Clinton-Eaton-Ingham County $205 - $615 5%
Cmh Detroit Wayne Integrated Health Network $205 - $615 5%
Cmh Genesee County $205 - $615 5%
Cmh Ionia County $205 - $615 5%
Cmh Jackson County/Lifeways $205 - $615 5%
Cmh Kalamazoo $205 - $615 5%
Cmh Kent County $205 - $615 5%
Cmh Lenawee County $205 - $615 5%
Cmh Livingston County $205 - $615 5%
Cmh Macomb $205 - $615 5%
Cmh Misc $205 - $615 5%
Cmh Monroe County $205 - $615 5%
Cmh Montcalm County $205 - $615 5%
Cmh Muskegon County $205 - $615 5%
Cmh Newaygo County $205 - $615 5%
Cmh North Country $205 - $615 5%
Cmh Northern Lakes County $205 - $615 5%
Cmh Oakland County $205 - $615 5%
Cmh Ottawa County $205 - $615 5%
Cmh Van Buren County $205 - $615 5%
Cmh Washtenaw County $205 - $615 5%
Cmh Wayne County/Carelink $205 - $615 5%
Cmh Wayne Cty/Com Liv Svcs $205 - $615 5%
Cmh West Mi County $205 - $615 5%
Community Benefit Health $205 - $615 5%
Community Care Behavorial Health $205 - $615 5%
Community Care Partners $205 - $615 5%
Community Health Choice $205 - $615 5%
Connections Csp $205 - $615 5%
County Coroner $205 - $615 5%
County Funding Generic $205 - $615 5%
Covid19 Hrsa Uninsured Testing And Treatment Fund $205 - $615 5%
Dean Wi Badgercare $205 - $615 5%
Delaware County Department Of Health $205 - $615 5%
Delaware First Health $205 - $615 5%
Delta Dental Nj $205 - $615 5%
Dph Tb Program $205 - $615 5%
Dscc $205 - $615 5%
Eastpointe Lme $205 - $615 5%
Family Health Network $205 - $615 5%
Freedom First Healthcare $205 - $615 5%
Fresno County Ccs $205 - $615 5%
Ghc Scw Wi Badgercare $205 - $615 5%
Harbor Health $205 - $615 5%
Health Safety Net $205 - $615 5%
Healthy Blue Ne $205 - $615 5%
Hennepin Health $205 - $615 5%
Id County Ada $205 - $615 5%
Id County Canyon $205 - $615 5%
Id County Cat Fund $205 - $615 5%
Id County Other $205 - $615 5%
Id County Payette $205 - $615 5%
Idaho Dept Health And Wellfare $205 - $615 5%
Idaho Womens Health Check $205 - $615 5%
Indiana Breast Cervical Cancer $205 - $615 5%
Inland Empire Health Plan $205 - $615 5%
Intercommunity Health Ohp $205 - $615 5%
Iowa Total Care $205 - $615 5%
Jai Medical System $205 - $615 5%
Kern Family Health Plan $205 - $615 5%
Keystone First $205 - $615 5%
Keystone First Chip $205 - $615 5%
La Care Health Plan $205 - $615 5%
Lakeland Care Inc $205 - $615 5%
Managed Health Services - Indiana $205 - $615 5%
Maryland Breast & Cervical Program $205 - $615 5%
Maryland Healthy Smiles - Scion Dental $205 - $615 5%
Maryland Physicians Care $205 - $615 5%
Massachusetts Behavioral Health Partnership $205 - $615 5%
Mdwise $205 - $615 5%
Medi-Cal $205 - $615 5%
Medi-Cal Healthnet $205 - $615 5%
Medstar Dc Healthy Family $205 - $615 5%
Medstar Md Health Choice $205 - $615 5%
Mo Home State Health Plan $205 - $615 5%
Molina Centennial Care $205 - $615 5%
Nascentia Health Options $205 - $615 5%
Nebraska Total Care $205 - $615 5%
New York Cancer Services Program $205 - $615 5%
Nextlevel Health $205 - $615 5%
Paramount Advantage $205 - $615 5%
Parkland Community Health Plan $205 - $615 5%
Partners Behavioral Lme $205 - $615 5%
Peach State Healthplan $205 - $615 5%
Philadelphia County Funding $205 - $615 5%
Presbyterian Centennial Care $205 - $615 5%
Prestige Health Choice $205 - $615 5%
Priority Partners $205 - $615 5%
Robert F Sing Program $205 - $615 5%
Rx 340B Pass Along $205 - $615 5%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $205 - $615 5%
Rx Medi-Cal $205 - $615 5%
Rx Meridian Rx $205 - $615 5%
Ryan White Florida Mssrp $205 - $615 5%
Sandhills Center Lme $205 - $615 5%
Screening For Life $205 - $615 5%
St Joseph County Hlth Dpt $205 - $615 5%
Stephenson Cty Health $205 - $615 5%
Sunshine State Health Plan $205 - $615 5%
Superior Health $205 - $615 5%
Tenncare $205 - $615 5%
Texas Children'S Health Plan $205 - $615 5%
Trillium Community Ohp $205 - $615 5%
Tufts Health Public Plans $205 - $615 5%
Vaya Health Lme $205 - $615 5%
Washtenaw Health Plan $205 - $615 5%
Wellsense Health Plan $205 - $615 5%
Wi Womens Wellness $205 - $615 5%
Meritain $317 - $602 8%
Moda Health $335 - $735 8%
Pacificsource Health Plans $342 - $639 9%
Asuris Northwest Health $344 - $642 9%
Blue Shield - Id (Regence) $344 - $796 9%
Healthcare Management Admin $344 - $642 9%
Webtpa $354 - $753 9%
Molina Marketplace $383 - $815 10%
First Choice Health $385 - $687 10%
Providence $385 - $687 10%
Mountain Health Co-Op $393 - $735 10%
Selecthealth $393 - $928 10%
Bcn Domestic $426 - $796 11%
Blue Benefit Administrators Of Massachusetts $426 - $796 11%
Blue Care Network $426 - $796 11%
Blue Distinction Transplant $426 - $796 11%
Blue Shield - Ca $426 - $796 11%
Blue Shield - Ny Highmark Northeastern $426 - $796 11%
Blue Shield - Ny Highmark Western $426 - $796 11%
Blue Shield - Pa (Highmark) $426 - $796 11%
Blue Shield - Wa (Regence) $426 - $796 11%
Health Choices $426 - $796 11%
Kaiser Domestic $426 - $796 11%
Pre-Employment $426 - $796 11%
Wc Domestic $426 - $796 11%
Geha $444 - $806 11%
Andrie Inc $545 - $1,012 14%
East Greenbush Central School District $545 - $1,012 14%
Genex Wc $545 - $1,012 14%
Healthsmart Workers Comp $545 - $1,012 14%
Jag Source $545 - $1,012 14%
New York State Insurance Fund $545 - $1,012 14%
Njm Insurance Group $545 - $1,012 14%
Rx Heatlhcomp $545 - $1,012 14%
Rx Restat $545 - $1,012 14%
Rx Saif Opdp Wc $545 - $1,012 14%
Rx Worker'S Comp $545 - $1,012 14%
Wc Accident Fund $545 - $1,012 14%
Wc Ace $545 - $1,012 14%
Wc Acs Federal Employees $545 - $1,012 14%
Wc Acuity $545 - $1,012 14%
Wc Advantage $545 - $1,012 14%
Wc Aegis $545 - $1,012 14%
Wc Aig $545 - $1,012 14%
Wc Aims $545 - $1,012 14%
Wc Alaska National Ins $545 - $1,012 14%
Wc Align Network $545 - $1,012 14%
Wc Allied $545 - $1,012 14%
Wc Am Trust N America $545 - $1,012 14%
Wc American Claims Mgmt $545 - $1,012 14%
Wc Amerisure $545 - $1,012 14%
Wc Amtrust $545 - $1,012 14%
Wc Asu Risk Mgt $545 - $1,012 14%
Wc Benetech $545 - $1,012 14%
Wc Berkley Admin $545 - $1,012 14%
Wc Broadspire $545 - $1,012 14%
Wc Broward County $545 - $1,012 14%
Wc Bunch & Associates $545 - $1,012 14%
Wc California State Comp Ins $545 - $1,012 14%
Wc California State Ins Fund $545 - $1,012 14%
Wc Capitol Area Health Consortium $545 - $1,012 14%
Wc Ccmsi $545 - $1,012 14%
Wc Chartis $545 - $1,012 14%
Wc Chubb $545 - $1,012 14%
Wc Cirma $545 - $1,012 14%
Wc City Of Albany $545 - $1,012 14%
Wc City Of Sioux City $545 - $1,012 14%
Wc Claims Mgmt Inc $545 - $1,012 14%
Wc Cna $545 - $1,012 14%
Wc Comp One Admin C/O Manageability $545 - $1,012 14%
Wc Compone Admin $545 - $1,012 14%
Wc Corvel $545 - $1,012 14%
Wc Ct Healthcare Trust $545 - $1,012 14%
Wc Donegal Insurance Group $545 - $1,012 14%
Wc Emc Insurance Company $545 - $1,012 14%
Wc Employee Mutual $545 - $1,012 14%
Wc Enablecomp $545 - $1,012 14%
Wc Encore Health Network $545 - $1,012 14%
Wc Erie $545 - $1,012 14%
Wc Esis $545 - $1,012 14%
Wc Evolutions $545 - $1,012 14%
Wc Fcci $545 - $1,012 14%
Wc Fed Ex $545 - $1,012 14%
Wc Federal Black Lung $545 - $1,012 14%
Wc Federated $545 - $1,012 14%
Wc Finley Occupational Health $545 - $1,012 14%
Wc First Agency/Occunet $545 - $1,012 14%
Wc Ford Motor $545 - $1,012 14%
Wc Fresno Unified Emp $545 - $1,012 14%
Wc Gallagher Bassett $545 - $1,012 14%
Wc General Motors $545 - $1,012 14%
Wc Generic $545 - $1,012 14%
Wc Genex Care For Ohio $545 - $1,012 14%
Wc Great West Casualty $545 - $1,012 14%
Wc Guarantee Insurance $545 - $1,012 14%
Wc Guard Insurance Company $545 - $1,012 14%
Wc Hab $545 - $1,012 14%
Wc Hartford $545 - $1,012 14%
Wc Hastings $545 - $1,012 14%
Wc Health Management $545 - $1,012 14%
Wc Heritage Summit $545 - $1,012 14%
Wc Hireright $545 - $1,012 14%
Wc Horizon $545 - $1,012 14%
Wc Icw Group $545 - $1,012 14%
Wc Idaho State Ins Fund $545 - $1,012 14%
Wc Intercare Insurance $545 - $1,012 14%
Wc Intermountain $545 - $1,012 14%
Wc Johns Eastern $545 - $1,012 14%
Wc Kemberton $545 - $1,012 14%
Wc Key Ins & Benefit Solutions $545 - $1,012 14%
Wc Liberty Mutual $545 - $1,012 14%
Wc Mac Risk Management $545 - $1,012 14%
Wc Massachusetts $545 - $1,012 14%
Wc Mdia $545 - $1,012 14%
Wc Meadowbrook Claim $545 - $1,012 14%
Wc Medical Administrators $545 - $1,012 14%
Wc Meijers $545 - $1,012 14%
Wc Memic $545 - $1,012 14%
Wc Mercy Workcare $545 - $1,012 14%
Wc Michigan $545 - $1,012 14%
Wc Michigan Millers Mutual $545 - $1,012 14%
Wc Mitchell Frankenmuth $545 - $1,012 14%
Wc Mra $545 - $1,012 14%
Wc Nationwide $545 - $1,012 14%
Wc Nca Comp $545 - $1,012 14%
Wc New York $545 - $1,012 14%
Wc New York Special Funds $545 - $1,012 14%
Wc North American Rishces $545 - $1,012 14%
Wc Northeast Health $545 - $1,012 14%
Wc Notre Dame $545 - $1,012 14%
Wc Novanet $545 - $1,012 14%
Wc O'Hara Corp $545 - $1,012 14%
Wc Occ Health Allen $545 - $1,012 14%
Wc Ohio Bureau $545 - $1,012 14%
Wc One Call Medical $545 - $1,012 14%
Wc Paradigm $545 - $1,012 14%
Wc Peerless $545 - $1,012 14%
Wc Pma $545 - $1,012 14%
Wc Praxis Health Network $545 - $1,012 14%
Wc Price Chopper $545 - $1,012 14%
Wc Procura Management $545 - $1,012 14%
Wc Qualcare $545 - $1,012 14%
Wc Quiktrip $545 - $1,012 14%
Wc Reny Company $545 - $1,012 14%
Wc Rev Claims $545 - $1,012 14%
Wc Risico $545 - $1,012 14%
Wc Rural Mutual $545 - $1,012 14%
Wc Saif Oregon $545 - $1,012 14%
Wc Secura $545 - $1,012 14%
Wc Sedgwick $545 - $1,012 14%
Wc Sentry $545 - $1,012 14%
Wc Sheakley Unicomp $545 - $1,012 14%
Wc Smile Lodge $545 - $1,012 14%
Wc Society $545 - $1,012 14%
Wc Srs $545 - $1,012 14%
Wc Taconic (Mro) $545 - $1,012 14%
Wc Taconic Farms $545 - $1,012 14%
Wc Travelers $545 - $1,012 14%
Wc Triad Group $545 - $1,012 14%
Wc Tristar $545 - $1,012 14%
Wc Troy Ny $545 - $1,012 14%
Wc Tyson $545 - $1,012 14%
Wc Unified Health Services $545 - $1,012 14%
Wc United Heartland $545 - $1,012 14%
Wc Us Dept Of Labor $545 - $1,012 14%
Wc Velocity $545 - $1,012 14%
Wc Walmart $545 - $1,012 14%
Wc West Bend $545 - $1,012 14%
Wc West Bend Mutual/Argent $545 - $1,012 14%
Wc Winnebago Industries $545 - $1,012 14%
Wc Yankee Trails $545 - $1,012 14%
Wc York Risk $545 - $1,012 14%
Wc Zenith $545 - $1,012 14%
Wc Zurich $545 - $1,012 14%
Allied National Global Care $547 - $983 14%
Asrm - Reliance Standard Life Insurance $547 - $983 14%
Christian Care Ministry $547 - $983 14%
Dean Health $547 - $983 14%
Fallon Health $547 - $983 14%
Family Life Insurance Company $547 - $983 14%
Ghc Scw $547 - $983 14%
International Benefit Administrators $547 - $983 14%
Lifetime Benefit Solutions $547 - $983 14%
Manhattan Life $547 - $983 14%
Medi Share $547 - $983 14%
Multiplan $547 - $983 14%
Pai $547 - $983 14%
Pan-American Life $547 - $983 14%
Paramount Hmo $547 - $983 14%
Phcs $547 - $983 14%
Trinity Health Share $547 - $983 14%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 351 Sw 9Th Street, Ontario, OR 97914
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals