CMS Price Transparency Data

Breast lump removal

Facility: Valley Regional Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,900
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Valley Regional Medical Center is $3,900. 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 0.97x the Medicare baseline. Located in 100 A Alton Gloor, Brownsville, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,900

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: $3,900 (97%)
Ins. Median: $3,900 (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
Texas Health Network $954 24%
Usa Mco $964 24%
Driscoll Childrens Health Plan $993 25%
United $1,034 - $13,940 26%
Molina Healthcare $1,060 26%
Aetna $1,217 - $5,078 30%
Superior Health Plan $2,369 59%
Healthcare Highways $3,041 76%
Curative Administrators $4,807 120%
Blue Cross Blue Shield $5,150 - $7,968 129%
Cigna $5,263 - $7,037 132%
Oscar $5,830 146%
Independent Medical System $7,227 181%
Humana $12,814 320%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 A Alton Gloor, Brownsville, TX 78526
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals