CMS Price Transparency Data

Breast lump removal

Facility: Christus St Michael Health System

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $3,759
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Christus St Michael Health System is $3,759. 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 2600 St Michael Dr, Texarkana, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,759

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: $3,759 (94%)
Ins. Median: $3,759 (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
Arkansas Total Care $320 8%
Empower Healthcare Solutions $326 8%
UnitedHealthcare $394 - $7,110 10%
Amerigroup $964 - $4,060 24%
Superior $964 24%
Texas True Choice $964 24%
Summit Community Care $983 25%
Molina $1,012 - $3,759 25%
Texas Children'S Health Plan $1,012 25%
Humana $2,366 - $3,759 59%
Blue Cross Blue Shield $3,302 - $8,028 83%
Aetna $3,759 - $6,450 94%
Christus Health $3,759 - $5,263 94%
Coventry $3,759 94%
Texas Healthspring $3,759 94%
Triwest $3,759 94%
Windsor $3,759 94%
Provider Partners Health Plan $3,872 97%
Texas Independence Health Plan $3,872 97%
State Of Oklahoma $3,943 99%
Shared Health Insurance Company $3,947 99%
Tribute Health Plan $3,947 99%
Five Point Credit Union $4,020 100%
Us Imaging Network $4,022 101%
Imperial Health Plan $4,135 103%
Medicare (plans) $4,135 103%
Procare Advantage $4,135 103%
Qualchoice $4,480 112%
Healthcare Highways $4,702 118%
Cigna $7,285 182%
Naphcare Inc. $7,518 188%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2600 St Michael Dr, Texarkana, TX 75503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals