CMS Price Transparency Data

Breast lump removal

Facility: Christus Santa Rosa Hospital-San Marcos

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,748
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Christus Santa Rosa Hospital-San Marcos is $3,748. 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 0.94x the Medicare baseline. Located in 1301 Wonder World Drive, San Marcos, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,748

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: $3,748 (94%)
Ins. Median: $3,748 (94% 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 $430 - $4,979 11%
Community First $964 24%
Blue Cross Blue Shield $983 - $7,604 25%
Amerigroup $1,012 - $4,008 25%
Texas Childrens Health Plan $1,012 25%
Superior $1,108 28%
Allwell $3,711 93%
Christus Health $3,711 - $5,195 93%
Humana $3,711 - $5,672 93%
Triwest $3,711 93%
Washington National $3,711 93%
Wellcare $3,711 93%
Aetna $3,785 95%
Cigna $3,822 - $7,553 96%
Provider Partners Health Plan $3,822 96%
Shared Health Insurance Company $3,897 97%
Devoted Health Plan $4,008 100%
Five Point Credit Union $4,020 100%
Sendero $6,346 159%
Naphcare Inc. $7,422 186%
Healthcare Highways $9,389 235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 Wonder World Drive, San Marcos, TX 78666
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals