CMS Price Transparency Data
Breast lump removal
Facility: Children's Hosp of Los Angeles
Billing Code: 19120 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 19120
- Insurance Median: $620
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.15x Medicare
The contracted insurance negotiated median rate for a Breast lump removal at Children's Hosp of Los Angeles is $620. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.15x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$620
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%)
Insurance Median: $620 (15%)
Ins. Median: $620 (15% 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 |
|---|---|---|
| Altamed | $295 - $15,517 | 7% |
| Caloptima | $295 | 7% |
| Valley Presbyterian Hospital | $302 | 8% |
| Medi-Cal | $302 | 8% |
| Choc Health Alliance | $378 | 9% |
| Health Net | $378 | 9% |
| St Francis Medical Center | $393 - $583 | 10% |
| Global Care Medical Group | $441 | 11% |
| El Proyecto Del Barrio | $441 | 11% |
| Watts Healthcare Mmc | $441 | 11% |
| Bella Vista Med Grp | $441 | 11% |
| Health Care La IPA | $441 | 11% |
| Premier Physicians Ntwk | $441 | 11% |
| Centinela Valley IPA | $441 | 11% |
| Community Family Care IPA | $453 | 11% |
| Hollywood Presbyterian Medical Center | $453 | 11% |
| Heritage Provider Network | $484 - $18,057 | 12% |
| Blue Cross Blue Shield | $498 - $5,397 | 12% |
| La Care | $502 - $15,800 | 13% |
| Serra Community Med Clinic | $518 | 13% |
| White Memorial Medical Center | $529 | 13% |
| Care 1St | $529 | 13% |
| Adventist Health Physicians | $544 - $16,928 | 14% |
| Cal Care IPA | $550 | 14% |
| Gold Coast Health Plan | $559 | 14% |
| Associated Hispanic Physicians IPA | $559 | 14% |
| Hispanic Physician IPA | $559 | 14% |
| Serendib Healthways Mmc | $559 | 14% |
| Beverly Hospital | $562 | 14% |
| San Judas Med Grp | $565 | 14% |
| Los Angeles Medical Center IPA | $565 | 14% |
| Alhambra Hospital Medical Center | $568 | 14% |
| Accountable Health | $577 | 14% |
| Souther California Hosp System - Mmc | $580 | 14% |
| Cencal Health | $583 | 15% |
| Pacific Alliance Medical Center | $592 | 15% |
| Blue Shield | $598 - $4,848 | 15% |
| Point Comfort Underwriters | $605 | 15% |
| Crown City Medical Group | $605 | 15% |
| Angeles IPA | $605 | 15% |
| Employee Health Systems Med Grp | $605 | 15% |
| Seaside Health Plan | $605 | 15% |
| Karing Physicians Medical Group | $617 | 15% |
| Imperial Health Holdings Medical Group | $617 | 15% |
| Regent Medical Group | $617 | 15% |
| Noble Community Medical Associates | $617 | 15% |
| Avalon IPA | $620 | 15% |
| Exceptional Care Medical Group | $620 - $21,536 | 15% |
| Primary Care and Pediatric IPA | $620 | 15% |
| Preferred IPA | $620 | 15% |
| Mabuhay Medical Group | $620 | 15% |
| Inland Empire Health Plan | $623 | 16% |
| Molina | $638 | 16% |
| Family Care Specialists | $638 | 16% |
| Family Health Alliance Med Grp | $650 | 16% |
| Applecare Medical Group | $668 - $18,339 | 17% |
| Community Care IPA Mmc | $668 | 17% |
| Dignity Health | $671 | 17% |
| Allied Pacific IPA | $710 | 18% |
| California Pacific Physicians Medical Group | $719 | 18% |
| Healthy New Life Medical Corp | $719 | 18% |
| Asian Community Medical Group | $719 | 18% |
| Kern Family Health Plan | $762 | 19% |
| Superior Choice Medical Group | $819 | 20% |
| Southland San Gabriel Valley Medical Group | $825 | 21% |
| Cigna | $4,077 | 102% |
| Champus | $4,885 | 122% |
| UnitedHealthcare | $6,553 - $12,329 | 164% |
| Medicare (plans) | $9,237 | 231% |
| Accarent Health | $9,404 | 235% |
| Sierra Health and Life Insurance Company | $10,000 | 250% |
| Delta Health Systems | $11,564 | 289% |
| Incentive Health Network | $17,398 | 435% |
| Gemcare IPA | $18,057 | 451% |
| Managed Care Systems | $18,339 | 458% |
| Providence Health Network | $18,809 | 470% |
| Ventura County Health Plan | $23,981 | 599% |
| Staywell Insurance | $25,000 | 625% |
| Good Samaritan Medical Group | $25,862 | 647% |
| Access Medical Group | $26,144 | 654% |
| Seoul Medical Group | $28,872 | 722% |
| Southern Atlantic Medical Group Mmc | $30,379 | 759% |