CMS Price Transparency Data

Breast lump removal

Facility: Baylor Scott & White Medical Center- College Stati

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $4,757
Cash Discount Price: $5,580
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Baylor Scott & White Medical Center- College Stati is $4,757. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,580. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 1.19x the Medicare baseline. Located in 700 Scott & White Drive, College Station, TX.

Cash / Self-Pay

$5,580

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,757

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: $5,580 (139%)

Insurance Median: $4,757 (119%)

Cash: $5,580 (139% of Medicare)

Ins. Median: $4,757 (119% 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
Blue Cross Blue Shield	$66 - $5,453	2%
UnitedHealthcare	$3,245 - $4,585	81%
Baylor Scott & White Health Plan	$3,384 - $5,927	85%
Humana	$3,592 - $6,510	90%
Superior Health Plan	$3,592	90%
Triwest	$3,592	90%
Corvel	$3,763	94%
Prime Health Services	$3,763	94%
American Health Plan	$3,772	94%
Procare Advantage	$3,772	94%
Cigna	$4,418 - $5,250	110%
Employers Health Network	$5,115	128%
Midcoast	$5,115	128%
Quiktrip	$5,115	128%
Healthsmart	$5,290 - $6,975	132%
Careworks Fka Rockport	$5,370	134%
Sedgwick	$5,370	134%
University Of Mary Hardin-Baylor	$5,394	135%
Independent Medical System	$5,580	139%
Imagine Health	$5,826	146%
Curative	$6,045	151%
First Health	$6,510	163%
Aetna	$6,688	167%
Private Health Care System	$6,975	174%
Three Rivers	$8,371	209%

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 $5,580.
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 Baylor Scott & White Medical Center- College Stati 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.