CMS Price Transparency Data

Breast lump removal

Facility: Arbor Health Morton Hospital

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $408
Cash Discount Price: $888
vs. Medicare Baseline: 0.10x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Arbor Health Morton Hospital is $408. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $888. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.10x the Medicare baseline. Located in 521 Adams Street, Morton, WA.

Cash / Self-Pay

$888

Average discount available for prompt cash payment at this facility.

Insurance Median

$408

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: $888 (22%)

Insurance Median: $408 (10%)

Cash: $888 (22% of Medicare)

Ins. Median: $408 (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.

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
Amerigroup-All Other Plans	$306	8%
Comm Health Healthy Options	$306	8%
Kaiser Mcaid	$306	8%
Molina Mcaid	$306	8%
UnitedHealthcare	$306 - $1,146	8%
Comm Health Basic Sub - All Other Plans	$367	9%
Aetna	$408 - $679	10%
Amerigroup Mcr Adv	$408	10%
Comm Health Mcr Adv	$408	10%
Healthnet Mcr Adv - All Plans	$408	10%
Humana	$408	10%
Mcr Railroad Mcr Adv - All Plans	$408	10%
Medicare (plans)	$408	10%
Premera Hmo Mcr Adv	$408	10%
Rural Health Mcare - All Plans	$408	10%
Regence Blue Shield Mcr Adv	$412	10%
Molina Mcr Adv	$428	11%
Wellcare Mcr Adv - All Plans	$428	11%
Comm Health Pebb	$551	14%
First Choice-All Plans	$570	14%
Kaiser Comm-All Other Plans	$576	14%
Molina Marketplace-All Other Plans	$859	21%
Regence Blue Shield Ump-All Other Plans	$1,002	25%
Premera First-All Other Plans	$1,289	32%
Cigna	$1,332	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 $888.
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 Arbor Health Morton 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.