CMS Price Transparency Data

Breast lump removal

Facility: Samaritan North Lincoln Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $631
Cash Discount Price: $748
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Samaritan North Lincoln Hospital is $631. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $748. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.16x the Medicare baseline. Located in 3043 Ne 28Th Street, Lincoln City, OR.

Cash / Self-Pay

$748

Average discount available for prompt cash payment at this facility.

Insurance Median

$631

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: $748 (19%)

Insurance Median: $631 (16%)

Cash: $748 (19% of Medicare)

Ins. Median: $631 (16% 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
Providence	$112 - $1,247	3%
Samaritan	$113 - $1,209	3%
Regence	$124 - $1,638	3%
Pacificsource	$126 - $1,135	3%
Devoted Health	$129 - $563	3%
Aetna	$296 - $1,141	7%
Moda	$296 - $1,247	7%
Cigna	$303 - $988	8%
Healthnet	$303 - $1,032	8%
Humana	$304 - $587	8%
Ihn	$551 - $562	14%
First Choice	$624 - $1,179	16%

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 $748.
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 Samaritan North Lincoln Hospital 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.