CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Mat-Su Regional Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $7,917
Cash Discount Price: $3,926
vs. Medicare Baseline: 6.48x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Mat-Su Regional Medical Center is $7,917. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,926. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 6.48x the Medicare baseline. Located in 2500 South Woodworth Loop, Palmer, AK.

Cash / Self-Pay

$3,926

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,917

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$1,222.56

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $1,222.56 (100%)

Cash / Self-Pay: $3,926 (321%)

Insurance Median: $7,917 (648%)

Cash: $3,926 (321% of Medicare)

Ins. Median: $7,917 (648% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $1,222.56 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 648% of the Medicare baseline (a markup of 548%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Veterans Eval Services	$489	40%
Medicare (plans)	$1,400	115%
Node Champva	$1,401	115%
Tricare	$1,401	115%
Medicaid / KanCare	$1,403	115%
Node Non Par Hospice Agree	$1,422	116%
Node Triwest	$1,422	116%
Node Va	$1,422	116%
Node Us Dept Of Labor	$1,778	145%
Self Pay	$3,926	321%
Ak Dept Of Corrections	$7,197	589%
Blue Cross Blue Shield	$7,341 - $7,982	600%
Hccmca	$7,851	642%
Aetna	$8,375	685%
Multiplan Phcs	$9,945	813%
Moda Assurance	$10,338	846%
Cigna	$10,364	848%
Carlie Trans Grp	$11,123	910%
UnitedHealthcare	$11,123	910%
First Choice Health	$11,777	963%
Multiplan Mpi	$11,908	974%
Plan Vista Solutions	$12,170	995%
Multiplan Wc	$12,431	1017%
One Health	$12,431	1017%
First Health Group	$12,562	1028%
Medical Control Network Solutions	$12,562	1028%

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 $3,926.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45380.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mat-Su Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45380.
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.