CMS Price Transparency Data

Breast lump removal

Facility: Temple Health - Chestnut Hill Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $4,023
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Temple Health - Chestnut Hill Hospital is $4,023. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.01x the Medicare baseline. Located in 8835 Germantown Avenue, Philadelphia, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,023

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%)

Insurance Median: $4,023 (101%)

Ins. Median: $4,023 (101% 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
Upmc Health Plan	$242 - $4,224	6%
Blue Cross Blue Shield	$608 - $12,817	15%
Keystone First	$1,342 - $4,103	34%
Pennsylvania Health And Wellness	$2,000 - $7,442	50%
Geisinger	$2,050 - $4,183	51%
Health Partners Plans	$2,208 - $4,224	55%
UnitedHealthcare	$2,354 - $4,023	59%
Cigna	$2,466 - $4,183	62%
Aetna	$3,950 - $5,350	99%
Point Comfort	$4,023	101%
Innovage	$4,103	103%
Vibra	$4,103	103%
Humana	$4,143	104%
Gateway Health Plan	$4,224	106%
Devon Health	$4,254	106%
Sunrise	$4,425	111%
Elder Health	$4,827	121%
Naphcare	$6,034	151%
Occunet	$6,637	166%

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 $X.
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 Temple Health - Chestnut Hill 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.