CMS Price Transparency Data

Breast lump removal

Facility: Christus Southeast Texas- St Elizabeth

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $3,835
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Christus Southeast Texas- St Elizabeth is $3,835. 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 0.96x the Medicare baseline. Located in 2830 Calder Avenue, Beaumont, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,835

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: $3,835 (96%)

Ins. Median: $3,835 (96% 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
UnitedHealthcare	$456 - $6,327	11%
Community Health Choice	$964 - $3,835	24%
Superior	$964	24%
Amerigroup	$1,012 - $4,142	25%
Molina	$1,012 - $3,835	25%
Texas Childrens Health Plan	$1,012	25%
Aetna	$2,242 - $3,835	56%
Humana	$2,336 - $3,835	58%
Mct Credit Union	$3,829	96%
Allwell	$3,835	96%
Arcadian Health Plan	$3,835	96%
Blue Cross Blue Shield	$3,835 - $5,181	96%
Christus Health	$3,835 - $5,370	96%
Coventry	$3,835	96%
Texas Healthspring	$3,835	96%
Triwest	$3,835	96%
Wellcare	$3,835	96%
Provider Partners Health Plan	$3,951	99%
Texas Independence Health Plan	$3,951	99%
Five Point Credit Union	$4,020	100%
Shared Health Insurance Company	$4,027	101%
Us Imaging Network	$4,104	103%
Devoted Health Plan	$4,142	104%
Imperial Health Plan	$4,219	105%
Medicare (plans)	$4,219	105%
Procare Advantage	$4,219	105%
Healthcare Highways	$4,543	114%
Partners Direct Health	$4,989	125%
Cigna	$6,039 - $7,833	151%
Adv Cardiovas Specialist	$7,671	192%
Naphcare Inc.	$7,671	192%

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 Christus Southeast Texas- St Elizabeth 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.