CMS Price Transparency Data

Breast lump removal

Facility: Comanche County Medical Center

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 19120
  • Insurance Median: $4,719
  • Cash Discount Price: $4,869
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Comanche County Medical Center is $4,719. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,869. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.18x the Medicare baseline. Located in 10201 Hwy 16, Comanche, TX.
Cash / Self-Pay
$4,869

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,719

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: $4,869 (122%)
Insurance Median: $4,719 (118%)
Cash: $4,869 (122% of Medicare)
Ins. Median: $4,719 (118% 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
Choicecare Comm - All Other Plans $2,771 69%
Choicecare Mcr Adv $2,771 69%
Humana $2,771 - $5,243 69%
Molina Mcr Adv - All Other Plans $2,771 69%
Pphp Mcr Adv - All Plans $2,771 69%
Superior Epo/Hmo - All Plans $2,771 69%
Swhp Mcr Adv $2,771 69%
Wellmed Mcr Adv - All Plans $2,771 69%
Alliance Wc - All Plans $4,157 104%
Aetna $4,719 118%
Molina Mcaid $4,719 118%
Swhp Mcaid $4,719 118%
Cigna $4,868 122%
Blue Cross Blue Shield $5,243 - $5,618 131%
Occunet - All Plans $5,618 140%
Swhp Comm - All Other Plans $5,992 150%
First Care Hmo - All Other Plans $6,366 159%
First Care Hmo Self Funded $6,366 159%
Mpi - All Plans $6,741 169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10201 Hwy 16, Comanche, TX 76442
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals