CMS Price Transparency Data

Breast lump removal

Facility: Woodland Heights Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,870
  • Cash Discount Price: $11,045
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Woodland Heights Medical Center is $3,870. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,045. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.97x the Medicare baseline. Located in 505 South John Redditt Drive, Lufkin, TX.
Cash / Self-Pay
$11,045

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,870

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: $11,045 (276%)
Insurance Median: $3,870 (97%)
Cash: $11,045 (276% of Medicare)
Ins. Median: $3,870 (97% 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
Veterans Eval Services $492 12%
Medicaid / KanCare $1,014 - $1,490 25%
UnitedHealthcare $1,014 - $27,209 25%
Superior $1,064 - $5,349 27%
Multiplan $1,235 - $52,159 31%
Amerigroup $1,490 37%
Blue Cross Blue Shield $2,450 - $8,959 61%
Cigna $2,456 61%
Self Pay $3,068 77%
Humana $3,870 97%
Medicare (plans) $3,870 97%
Node Triwest $3,933 98%
Node Va $3,933 98%
American Health Mcr Adv $4,025 101%
Provider Partners Health Plan $4,051 101%
Node Amerigroup Mcr Adv $4,064 102%
Node Procare Advantage $4,064 102%
Node Us Dept Of Labor $4,917 123%
Angelina County $5,900 147%
Corporate Remedies $5,900 147%
Partners Direct Health $5,900 147%
Node Brookshire Brothers $6,883 172%
Node Brookshire Brothers Work Comp Tx $7,277 182%
Usa Managed Care $7,316 183%
Tricare $7,433 - $7,825 186%
Department Of Veterans Affairs $7,825 196%
Work Comp $7,867 197%
Texas Rehab Commission $15,341 384%
Aetna $32,523 - $52,159 813%
Unicare $36,818 920%
Galaxy Health Network $52,159 1304%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 505 South John Redditt Drive, Lufkin, TX 75904
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals