CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Medical Center Enterprise

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,095
  • Cash Discount Price: $3,547
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Medical Center Enterprise is $1,095. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,547. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.90x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
$3,547

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,095

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: $3,547 (290%)
Insurance Median: $1,095 (90%)
Cash: $3,547 (290% of Medicare)
Ins. Median: $1,095 (90% 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
Al Maternity Waiver Program $291 24%
Veterans Eval Services $371 30%
Medicaid / KanCare $383 - $631 31%
Blue Cross Blue Shield $1,015 - $1,282 83%
Humana $1,015 83%
Medicare (plans) $1,015 83%
UnitedHealthcare $1,015 - $2,468 83%
Select Health $1,025 84%
Covenant Hospice $1,031 84%
Dayspring Hospice $1,031 84%
Node Hospice Non Par $1,031 84%
Node Va $1,031 84%
Southerncare Hospice $1,031 84%
Healthspring $1,035 85%
Node Devoted Health Mcr Adv $1,035 85%
Node Clover Mcr Adv $1,042 85%
Aetna $1,045 - $27,588 85%
Node Wellcare Mcr Adv $1,052 86%
Eon Health $1,066 87%
Wiregrass Hospice $1,095 90%
Node Us Dept Of Labor $1,289 105%
Ambetter / Centene $1,547 127%
Cigna $1,688 - $10,932 138%
Occunet $1,805 148%
Self Pay $3,547 290%
Tricare $5,963 488%
Node Champva $6,277 513%
American Employee Alliance $15,764 1289%
Alamed $23,647 1934%
City Of Enterprise $23,647 1934%
Affordable Health $27,588 2257%
Health Choice $27,588 2257%
Novanet Ppo $27,588 2257%
Coventry Work Comp Al $29,007 2373%
Multiplan $29,164 - $30,347 2385%
Wc Dept Ind Relations $31,529 2579%
Corvel $33,499 2740%
Galaxy Health $35,470 2901%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals