CMS Price Transparency Data

Breast lump removal

Facility: University Health System, Inc

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $819
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.20x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at University Health System, Inc is $819. 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 0.20x the Medicare baseline. Located in 1924 Alcoa Highway, Knoxville, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$819

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: $819 (20%)
Ins. Median: $819 (20% 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
Blue Cross Blue Shield $316 - $3,671 8%
Bluecare $338 - $343 8%
Tenncare $343 9%
UnitedHealthcare $366 - $4,184 9%
Aetna $381 - $3,636 10%
Humana $381 - $3,497 10%
Nhc $381 - $3,706 10%
Cigna $384 - $3,497 10%
American Health $392 - $3,706 10%
Choicecare $413 - $476 10%
Coventry $517 - $1,925 13%
Multiplan $517 13%
Novanet $548 - $637 14%
First Health $618 15%
Beechstreet $647 16%
Nx Health 1 $723 18%
Wellpoint $2,356 - $3,706 59%
Devoted Health $3,636 91%
Wellcare-Windsor Medadv $3,671 92%
Medicare (plans) $3,706 - $3,741 93%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1924 Alcoa Highway, Knoxville, TN 37920
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals