CMS Price Transparency Data

Breast lump removal

Facility: Memorial Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $398
  • Cash Discount Price: $328
  • vs. Medicare Baseline: 0.10x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Memorial Medical Center is $398. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $328. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.10x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$328

Average discount available for prompt cash payment at this facility.

Insurance Median
$398

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: $328 (8%)
Insurance Median: $398 (10%)
Cash: $328 (8% of Medicare)
Ins. Median: $398 (10% 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
Ambetter / Centene $150 4%
Healthcare Highways-All Plans $305 8%
Prime Healthcare Services-All Plans $328 8%
Blue Cross Blue Shield $351 - $375 9%
Humana $375 9%
Triwest Va Pccc-All Plans $387 10%
Amerigroup Mcr Adv-All Other Plans $395 10%
Care Improvement Plus - All Other Plans $395 10%
Care Improvement Plus Mcr $395 10%
Superior Allwell Mcr Adv-All Other Plans $395 10%
UnitedHealthcare $395 - $691 10%
Universal American Mcr-All Other Plans $395 10%
Corvel Work Comp-All Plans $398 10%
Independent Med Sys Ppo-All Plans $398 10%
Multiplan Mcr Adv $398 10%
Multiplan Phcs Ppo-All Other Plans $398 10%
Provider Select Ppo-All Plans $398 10%
Three Rivers Ppo-All Plans $398 10%
Usa Mso - All Plans $398 10%
Universal American Snp $414 10%
Amerigroup Chip $469 12%
Amerigroup Star $469 12%
Amerigroup Star Kids $469 12%
Amerigroup Star Plus $469 12%
Comm Health Chip $469 12%
Comm Health Perinatal-All Other Plans $469 12%
Molina Chip/Star-All Plans $469 12%
Scott & White Chip/Star-All Plans $469 12%
Superior Chip/Star $469 12%
Texas Childrens Hp - All Plans $469 12%
Comm Health Mcaid Hmo $492 12%
Comm Health Star $492 12%
Coventry First Hlth Hmo Ppo-All Other Plans $493 12%
Coventry First Hlth Mcr Adv $493 12%
Capstar Health Network-All Plans $514 13%
Cigna $514 13%
Galaxy Health Network-All Plans $572 14%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals