CMS Price Transparency Data

Breast lump removal

Facility: Yoakum County Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $1,669
Cash Discount Price: $4,301
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Yoakum County Hospital is $1,669. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,301. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.42x the Medicare baseline. Located in 412 Mustang Avenue, Denver City, TX.

Cash / Self-Pay

$4,301

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,669

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: $4,301 (108%)

Insurance Median: $1,669 (42%)

Cash: $4,301 (108% of Medicare)

Ins. Median: $1,669 (42% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Healthsmart	$295 - $6,138	7%
Aetna	$383 - $6,174	10%
Humana	$401 - $4,721	10%
UnitedHealthcare	$401 - $5,811	10%
90 Degree Benefits	$670 - $3,632	17%
Cigna	$870 - $2,000	22%
Insurance Services Of Lubbock	$870 - $2,750	22%
Firstcare	$884 - $5,085	22%
Multiplan	$884 - $6,356	22%
Dars	$937 - $5,085	23%
Phcs	$1,138 - $6,174	28%
Capstar	$1,205 - $6,537	30%
Provider Network	$1,306 - $7,082	33%
Blue Cross Blue Shield	$1,339 - $7,264	33%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $4,301.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 19120.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Yoakum County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 19120.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.