CMS Price Transparency Data

Breast lump removal

Facility: Sweeny Community Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $230
  • Cash Discount Price: $221
  • vs. Medicare Baseline: 0.06x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Sweeny Community Hospital is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $221. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.06x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.
Cash / Self-Pay
$221

Average discount available for prompt cash payment at this facility.

Insurance Median
$230

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: $221 (6%)
Insurance Median: $230 (6%)
Cash: $221 (6% of Medicare)
Ins. Median: $230 (6% 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
Blue Cross Blue Shield $111 - $184 3%
Evercare Mcaid $184 5%
UnitedHealthcare $199 - $425 5%
Aetna $214 - $295 5%
Amerigroup Mcr Adv - All Other Plans $214 5%
Community Hlth Choice Him - All Other Plans $214 5%
Coventry Mcr Adv $214 5%
Molina Mcr Adv - All Other Plans $214 5%
Superior Hp Mcr Adv-All Other Plans $214 5%
Wellcare Mcare - All Plans $214 5%
Care Improvement Mcr - All Plans $216 5%
Choicecare Mcr Adv - All Plans $216 5%
Humana $221 - $240 6%
Cigna $240 6%
Community Hlth Choice Star $260 6%
Molina Mcaid $260 6%
Superior Hp Mcaid $260 6%
Tx Chlidrens Hp Mcaid - All Plans $260 6%
Tx True Choice Mcaid - All Plans $260 6%
Beech Street - All Plans $277 7%
Community Care Network - All Plans $295 7%
Galaxy Health Network - All Plans $332 8%
Multiplan - All Plans $332 8%
Evercare Mcr Adv - All Other Plans $358 9%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 305 North McKinney, Sweeny, TX 77480
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals