CMS Price Transparency Data

Breast lump removal

Facility: Cannon Memorial Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $397
  • Cash Discount Price: $279
  • vs. Medicare Baseline: 0.10x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Cannon Memorial Hospital is $397. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $279. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.10x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.
Cash / Self-Pay
$279

Average discount available for prompt cash payment at this facility.

Insurance Median
$397

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: $279 (7%)
Insurance Median: $397 (10%)
Cash: $279 (7% of Medicare)
Ins. Median: $397 (10% 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 $277 - $358 7%
Absolute Total Care [58] $283 - $365 7%
Humana $291 - $1,106 7%
Select Health Of Sc [637] $291 - $319 7%
Aetna $384 - $614 10%
Blue Choice Health Plan [922] $384 - $611 10%
Blue Cross Blue Shield $384 - $552 10%
Devoted Health Alt Payer [9401] $384 - $391 10%
Devoted Health [94] $384 - $391 10%
Medicare (plans) $384 - $427 10%
UnitedHealthcare $384 - $657 10%
Vaccn - Va Community Care Network [16] $384 10%
Veterans Administration [633] $384 10%
Cigna $395 - $690 10%
Molina Dual Options Alt Payer [1501] $395 10%
Molina Dual Options [15] $395 10%
Absolute Total Care Mcr Plans Alt Payer [4101] $397 10%
Absolute Total Care Mcr Plans [41] $397 10%
Bright Health Alt Payer [1001] $397 - $427 10%
Champva [604] $397 10%
Tricare $397 10%
First Choice Vip Careplus Alt Payer [3301] $403 10%
First Choice Vip [33] $403 10%
Nhc Advantage Alt Payer [6101] $403 10%
Nhc Advantage [61] $403 10%
Planned Administrators [886] $436 11%
Thomas Cooper & Company [315] $436 11%
Bright Health [11] $511 13%
Employee Benefit Management Services [869] $523 13%
Ambetter / Centene $549 14%
First Choice Next [96] $556 14%
Molina Marketplace [97] $556 14%
Mail Handlers Benefit Plan [327] $614 15%
Rural Carrier Benefit Plan [406] $614 15%
Workers Compensation [622] $614 15%
Preferred Administrators [19] $654 16%
Geha [302] $657 16%
Golden Rule Ins Co [584] $657 16%
Edison Health Solutions [95] $671 17%
Healthscope [98] $671 17%
Nalc Health Benefit Plan [291] $690 17%
Medcost [206] $817 20%
Phcs [940] $959 24%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 123 W G Acker Drive, Pickens, SC 29671
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals