CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Gadsden Regional Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,373
  • Cash Discount Price: $5,574
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Gadsden Regional Medical Center is $1,373. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,574. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.12x the Medicare baseline. Located in 1007 Goodyear Avenue, Gadsden, AL.
Cash / Self-Pay
$5,574

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,373

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: $5,574 (456%)
Insurance Median: $1,373 (112%)
Cash: $5,574 (456% of Medicare)
Ins. Median: $1,373 (112% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $371 30%
Medicaid / KanCare $383 31%
Blue Cross Blue Shield $1,056 86%
Humana $1,056 86%
Medicare (plans) $1,056 86%
Node Viva Mcr Adv $1,056 86%
Node Select Health Mcr Adv $1,067 87%
Amedisys Hospice $1,073 88%
Gadsden Hospice $1,073 88%
Node Non Par Hospice Agree $1,073 88%
Node Va $1,073 88%
Southern Care Hospice $1,073 88%
UnitedHealthcare $1,073 - $4,495 88%
Cigna $1,077 - $6,340 88%
Node Devoted Health Mcr Adv $1,077 88%
Node Clover Health Mcr Adv $1,084 89%
Aetna $1,088 - $24,063 89%
Node Wellcare Mcr Adv $1,095 90%
Node Eon Mcr Adv $1,109 91%
Prime Health $1,130 - $33,563 92%
Node Us Dept Of Labor $1,342 110%
Ambetter / Centene $1,610 132%
Viva Healthcare $3,900 319%
Tricare $4,984 408%
Node Champva $5,247 429%
Self Pay $5,574 456%
American Employee Alliance $18,581 1520%
Multiplan $26,478 - $29,266 2166%
Magellan Behavioral $27,872 2280%
First Health $32,517 - $37,511 2660%
Beech Street $33,911 2774%
Alamed Wc $34,840 2850%
Focus Health $35,537 2907%
Coventry Work Comp Al $36,327 2971%
Work Comp $39,485 3230%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Goodyear Avenue, Gadsden, AL 35903
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals