CMS Price Transparency Data

Breast lump removal

Facility: Curry General Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $1,332
Cash Discount Price: $1,624
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Curry General Hospital is $1,332. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,624. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.33x the Medicare baseline. Located in 94220 Fourth Street, Gold Beach, OR.

Cash / Self-Pay

$1,624

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,332

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: $1,624 (41%)

Insurance Median: $1,332 (33%)

Cash: $1,624 (41% of Medicare)

Ins. Median: $1,332 (33% 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
Tricare	$415 - $596	10%
Covid19 Hrsa Uninsured Testing And Treatment Fund [2271]	$445	11%
Medicare (plans)	$445	11%
Blue Cross Blue Shield	$679 - $1,915	17%
Medicaid / KanCare	$839 - $1,230	21%
Department Of Corrections [1051]	$866 - $1,245	22%
Coordinated Care Commercial [1649]	$1,132 - $1,628	28%
Pacificsource [1148]	$1,132 - $1,628	28%
Moda [512]	$1,143 - $1,724	29%
Multiplan [1131]	$1,212 - $1,743	30%
First Choice Health Admin [1294]	$1,250	31%
First Choice [528]	$1,250	31%
Asuris [1258]	$1,265 - $1,819	32%
Operating Engineers [1144]	$1,265 - $1,819	32%
Regence [1351]	$1,265 - $1,915	32%
Cigna	$1,305 - $1,915	33%
Coventry First Health Managed Care [1774]	$1,305 - $1,877	33%
Coventry Health [1046]	$1,305 - $1,877	33%
Providence Health Plan Plm Alt [1692]	$1,305 - $1,877	33%
Providence Health Plan [567]	$1,305 - $1,877	33%
Aetna	$1,332 - $1,915	33%
Employee Bene Admin Mgmt [525]	$1,332 - $1,915	33%
Geha [531]	$1,332 - $1,915	33%
Mailhandlers Benefit Pln [547]	$1,332 - $1,915	33%
Meritain [550]	$1,332 - $1,915	33%
Nw Sheet Metal Workers [597]	$1,332 - $1,915	33%
Trustmark [524]	$1,332 - $1,915	33%
UnitedHealthcare	$1,332 - $1,915	33%
Zenith Administrators [586]	$1,332 - $1,915	33%
Allcare Alt [2598]	$2,000	50%
Allcare [1695]	$2,000	50%

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 $1,624.
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 Curry General 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.