CMS Price Transparency Data

Breast lump removal

Facility: Geisinger-Lewistown Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $6,966
  • Cash Discount Price: $6,140
  • vs. Medicare Baseline: 1.74x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Geisinger-Lewistown Hospital is $6,966. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,140. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.74x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.
Cash / Self-Pay
$6,140

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,966

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: $6,140 (153%)
Insurance Median: $6,966 (174%)
Cash: $6,140 (153% of Medicare)
Ins. Median: $6,966 (174% 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
Medicaid / KanCare $173 4%
Geisinger Family Plan $185 5%
Amerihealth $190 5%
Upmc Health Plan $203 - $11,890 5%
Health Partners $208 5%
Upmc Chip $216 5%
Blue Cross Blue Shield $3,250 - $11,203 81%
Geisinger Health Plan $3,714 - $17,407 93%
Medicare (plans) $3,714 93%
Advantra $3,751 94%
Humana $3,751 94%
Aetna $4,047 - $7,220 101%
Cigna $4,283 - $7,814 107%
Christian Healthcare Ministries $4,952 - $7,428 124%
Christian Health Aid $7,923 - $11,885 198%
Three Rivers Provider Network Inc. $7,923 - $11,885 198%
Multiplan $8,418 - $12,628 210%
Ambetter / Centene $8,913 223%
Healthsmart Payors Organization $8,914 - $13,370 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 Highland Avenue, Lewistown, PA 17044
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals