CMS Price Transparency Data

Breast lump removal

Facility: Mission Regional Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,973
  • Cash Discount Price: $3,914
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Mission Regional Medical Center is $3,973. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,914. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.99x the Medicare baseline. Located in 900 South Bryan Road, Mission, TX.
Cash / Self-Pay
$3,914

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,973

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: $3,914 (98%)
Insurance Median: $3,973 (99%)
Cash: $3,914 (98% of Medicare)
Ins. Median: $3,973 (99% 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
Cigna $1,922 - $4,031 48%
Blue Cross Blue Shield $3,757 - $4,363 94%
Aetna $3,914 98%
Medicare (plans) $3,914 98%
Superior Health Plan $3,914 - $5,088 98%
Tricare $3,914 98%
UnitedHealthcare $3,914 98%
Wellmed $3,914 98%
Worker Comp $3,914 98%
Molina $4,110 - $6,067 103%
Imperial Insurance Companies $4,149 104%
Employer Direct Healthcare $5,088 127%
Frontier Health (Fka Asserta Health) $5,088 127%
Magic Valley Electric Cooperative $5,088 127%
Corporate Remedies $5,871 147%
Naphcare $6,067 152%
Baker Benefits Administrators $7,828 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 900 South Bryan Road, Mission, TX 78572
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals