CMS Price Transparency Data

Breast lump removal

Facility: Christus Santa Rosa Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $2,816
  • Cash Discount Price: $1,685
  • vs. Medicare Baseline: 0.70x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Christus Santa Rosa Medical Center is $2,816. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,685. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.70x the Medicare baseline. Located in 11212 State Hwy 151, San Antonio, TX.
Cash / Self-Pay
$1,685

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,816

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: $1,685 (42%)
Insurance Median: $2,816 (70%)
Cash: $1,685 (42% of Medicare)
Ins. Median: $2,816 (70% 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
Blue Cross Blue Shield $128 - $4,150 3%
UnitedHealthcare $417 - $5,148 10%
Amerigroup $422 - $3,883 11%
Community First $422 - $1,012 11%
Humana $480 - $3,596 12%
Aetna $964 - $3,596 24%
Driscoll Children'S Health Plan $964 24%
El Paso First $964 24%
First Care $964 24%
Molina $964 - $3,596 24%
Superior $964 - $3,596 24%
Texas Childrens Health Plan $1,012 25%
Cigna $1,302 - $6,600 33%
Community First Health Plan $1,690 - $3,212 42%
Christian Brothers Services $1,936 - $3,680 48%
First Health $2,288 - $4,349 57%
Healthsmart $2,288 - $5,353 57%
Multiplan $2,288 - $4,349 57%
Phcs $2,288 - $4,349 57%
Medicus Internatiaonal $2,640 - $5,018 66%
Beech Street $2,816 - $5,353 70%
Health Management Network $2,816 - $5,353 70%
Provider Select $2,816 - $5,353 70%
National Choicecare $3,344 - $6,356 84%
Allwell $3,596 90%
Christus Health $3,596 - $5,034 90%
Coventry $3,596 90%
Texas Healthspring $3,596 90%
Triwest $3,596 90%
Wellcare $3,596 90%
Provider Partners Health Plan $3,703 93%
Texas Independence Health Plan $3,703 93%
Shared Health Insurance Company $3,775 94%
Us Imaging Network $3,847 96%
Devoted Health Plan $3,883 97%
Imperial Health Plan $3,955 99%
Medicare (plans) $3,955 99%
Procare Advantage $3,955 99%
Five Point Credit Union $4,020 100%
Employer Direct $4,315 108%
Healthcare Highways $4,543 114%
Gilsbar Inc. $4,674 117%
Naphcare Inc. $7,191 180%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11212 State Hwy 151, San Antonio, TX 78251
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals