CMS Price Transparency Data

Breast lump removal

Facility: Tennova Healthcare - Clarksville

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,095
  • Cash Discount Price: $4,817
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Tennova Healthcare - Clarksville is $4,095. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,817. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.02x the Medicare baseline. Located in 651 Dunlop Lane, Clarksville, TN.
Cash / Self-Pay
$4,817

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,095

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: $4,817 (120%)
Insurance Median: $4,095 (102%)
Cash: $4,817 (120% of Medicare)
Ins. Median: $4,095 (102% 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
Tennessee Breast And Cervical Screening Program $373 9%
Veterans Eval Services $461 12%
Aetna $896 - $5,612 22%
Medicaid / KanCare $1,250 - $6,208 31%
UnitedHealthcare $1,250 - $4,000 31%
Amerigroup $2,333 58%
Cigna $3,666 - $8,341 92%
Tricare $3,678 92%
Humana $3,809 - $5,463 95%
Medicare (plans) $3,809 95%
Node Windsor Mcr Dual $3,809 95%
Node Devoted Health Mcr Adv $3,870 97%
Node Bluecare Plus Tn Mcr Adv $3,871 97%
Node Champva $3,871 97%
Node Hospice Non Par Agree $3,871 97%
Node Va $3,871 97%
Node Wellcare Mcr Adv $3,871 97%
American Health $3,885 97%
Node Ascension Complete Mcr Adv $3,885 97%
Node Farm Bureau Mcr Adv $3,885 97%
Node Healthspring Mcr Adv $3,885 97%
Node Amerigroup Mcr Adv $4,000 100%
Node Nhc Mcr Adv $4,190 105%
Blue Cross Blue Shield $4,445 111%
Ky Work Comp $4,711 118%
Self Pay $4,817 120%
Node Us Dept Of Labor $4,839 121%
Corvel $5,457 136%
Rockport Work Comp Tn $5,457 136%
Novanet Work Comp Tn $5,629 141%
Prime Health Work Comp Tn $5,629 141%
Tn Work Comp $5,744 144%
Wellcare $6,208 155%
Ambetter / Centene $7,162 179%
Node Valenz Access $7,742 194%
Naphcare $8,710 218%
Oscar $10,597 265%
Center Care $16,140 403%
Correct Care Solutions $22,348 559%
First Health $22,348 559%
Multiplan $23,589 590%
Phcs $23,589 590%
Prime Health Services $23,589 590%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 Dunlop Lane, Clarksville, TN 37040
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals