CMS Price Transparency Data
Breast lump removal
Facility: Seattle Children's Hospital
Billing Code: 19120 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 19120
- Insurance Median: $986
- Cash Discount Price: $32,707
- vs. Medicare Baseline: 0.25x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Seattle Children's Hospital is $986. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32,707. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.25x the Medicare baseline. Located in 4800 Sand Point Way Ne, Po Box C-5371, Seattle, WA.
Cash / Self-Pay
$32,707
Average discount available for prompt cash payment at this facility.
Insurance Median
$986
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: $32,707 (818%)
Insurance Median: $986 (25%)
Cash: $32,707 (818% of Medicare)
Ins. Median: $986 (25% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Child Hearing League [17301] | $244 | 6% |
| Hospice [17306] | $244 | 6% |
| Maple Lane School [17309] | $244 | 6% |
| Medicaid / KanCare | $244 | 6% |
| Chpw [15802] | $252 | 6% |
| Coordinated Care [15815] | $257 | 6% |
| Icw Wellpoint [15822] | $257 | 6% |
| Kaiser [15818] | $257 | 6% |
| Molina [15809] | $257 | 6% |
| Opticare [15895] | $257 | 6% |
| Wellpoint [15814] | $257 | 6% |
| Ubh Community & State [15819] | $269 | 7% |
| UnitedHealthcare | $269 - $1,099 | 7% |
| Eye Quest [15894] | $281 | 7% |
| Usfhp [12208] | $520 | 13% |
| Coordinated Care [12267] | $714 | 18% |
| Chpw Cascade [12228] | $724 | 18% |
| Molina Marketplace [12831] | $746 | 19% |
| Regence Ump [12263] | $845 | 21% |
| Pb Premera [11601] | $951 | 24% |
| Premera [11600] | $951 | 24% |
| Asuris [11900] | $984 | 25% |
| Asuris [11913] | $984 | 25% |
| Bridgespan Health Company [11906] | $984 | 25% |
| Pb Regence [11908] | $984 | 25% |
| Regence [11903] | $984 | 25% |
| Regence [11909] | $984 | 25% |
| Administrators [13102] | $986 | 25% |
| Allied [13129] | $986 | 25% |
| Assurant Health Fc [13135] | $986 | 25% |
| Coastal Administrative [13140] | $986 | 25% |
| Ebms Fc [13144] | $986 | 25% |
| First Choice [13399] | $986 | 25% |
| Health Alliance [13233] | $986 | 25% |
| Ilwu-Pma [13158] | $986 | 25% |
| Loomis Benefits West [13161] | $986 | 25% |
| Meritain Health [13229] | $986 | 25% |
| Moda Fc [13219] | $986 | 25% |
| Myers Stevens & Toohey [13169] | $986 | 25% |
| Pacific Underwriters [13175] | $986 | 25% |
| Personify Fc [13155] | $986 | 25% |
| Providence Health Plan [13181] | $986 | 25% |
| Rehn & Associates [13182] | $986 | 25% |
| Samaritan Health [12265] | $986 | 25% |
| Starmark [13103] | $986 | 25% |
| Tongass Timber Trust [13202] | $986 | 25% |
| Trusteed Plans [13186] | $986 | 25% |
| Trustmark Life Insurance [13203] | $986 | 25% |
| Welfare Pension [13120] | $986 | 25% |
| Wship [13121] | $986 | 25% |
| Zenith American Solutions [13195] | $986 | 25% |
| Kaiser [13400] | $1,009 | 25% |
| Kaiser [13401] | $1,009 | 25% |
| Aetna | $1,012 | 25% |
| Ameriben [11006] | $1,012 | 25% |
| Christian Brothers [11001] | $1,012 | 25% |
| Coresource [11004] | $1,012 | 25% |
| Ebms [11003] | $1,012 | 25% |
| Meritain [12251] | $1,012 - $1,419 | 25% |
| Moda [11009] | $1,012 | 25% |
| Preferred One [11008] | $1,012 | 25% |
| Web Tpa [11007] | $1,012 | 25% |
| Allegiance [12264] | $1,017 | 25% |
| Cigna | $1,017 | 25% |
| Personify [12270] | $1,017 | 25% |
| Providence Health Plan [12289] | $1,017 | 25% |
| Tufts Health Plan [12279] | $1,017 | 25% |
| Claritev [12299] | $1,419 | 35% |
| Ebms [12241] | $1,419 | 35% |
| Health Alliance [12266] | $1,419 | 35% |
| Humana | $1,419 | 35% |
| Key Benefit Admin [12276] | $1,419 | 35% |
| Medical Mutual [12233] | $1,419 | 35% |
| Moda [12842] | $1,419 | 35% |
| Nippon Life Insurance [12232] | $1,419 | 35% |
| Pehp [12235] | $1,419 | 35% |
| Preferredone Admin Services [12236] | $1,419 | 35% |
| Select Health [12277] | $1,419 | 35% |