CMS Price Transparency Data

Breast lump removal

Facility: Titus Regional Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $601
Cash Discount Price: $1,006
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Titus Regional Medical Center is $601. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,006. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.15x the Medicare baseline. Located in 2001 N Jefferson, Mount Pleasant, TX.

Cash / Self-Pay

$1,006

Average discount available for prompt cash payment at this facility.

Insurance Median

$601

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: $1,006 (25%)

Insurance Median: $601 (15%)

Cash: $1,006 (25% of Medicare)

Ins. Median: $601 (15% 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
Christus Health Plan	$295	7%
Humana	$295 - $1,205	7%
Tricare	$295	7%
Triwest	$295 - $1,205	7%
UnitedHealthcare	$295 - $1,316	7%
Texas Mutual	$304	8%
Curative	$324	8%
Superior	$349	9%
Aetna	$383 - $627	10%
Blue Cross Blue Shield	$415 - $1,676	10%
Healthcare Highways	$546	14%
Claritev	$574	14%
Healthsmart	$1,173	29%
Cigna	$1,341	34%
Galaxy Health	$1,592	40%

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 $1,006.
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 Titus Regional Medical Center 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.