CMS Price Transparency Data

Breast lump removal

Facility: Christus Spohn Hospital Kleberg

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,454
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.86x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Christus Spohn Hospital Kleberg is $3,454. 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 0.86x the Medicare baseline. Located in 1311 East General Cavazos Blvd, Kingsville, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,454

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: $3,454 (86%)
Ins. Median: $3,454 (86% 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
UnitedHealthcare $421 - $4,790 11%
Blue Cross Blue Shield $964 - $5,181 24%
Molina $964 - $3,876 24%
Superior $964 - $3,876 24%
Driscoll Children'S Health Plan $983 25%
Texas Childrens Health Plan $1,012 25%
Cigna $1,691 - $2,070 42%
Humana $2,235 - $3,876 56%
Aetna $2,581 - $3,876 65%
Healthcare Highways $2,715 68%
Allwell $3,876 97%
Christus Health $3,876 - $5,426 97%
Coventry $3,876 97%
Texas Healthspring $3,876 97%
Triwest $3,876 97%
Wellcare $3,876 97%
Provider Partners Health Plan $3,992 100%
Five Point Credit Union $4,020 100%
Shared Health Insurance Company $4,069 102%
Us Imaging Network $4,147 104%
Amerigroup $4,186 105%
Devoted Health Plan $4,186 105%
Imperial Health Plan $4,263 107%
Medicare (plans) $4,263 107%
Procare Advantage $4,263 107%
Naphcare Inc. $7,751 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1311 East General Cavazos Blvd, Kingsville, TX 78363
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals