CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Flowers Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,421
  • Cash Discount Price: $4,812
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Flowers Hospital is $1,421. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,812. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.16x the Medicare baseline. Located in 4370 West Main Street, Dothan, AL.
Cash / Self-Pay
$4,812

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,421

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: $4,812 (394%)
Insurance Median: $1,421 (116%)
Cash: $4,812 (394% of Medicare)
Ins. Median: $1,421 (116% 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%
Alabama Rehab $383 31%
Medicaid / KanCare $383 - $631 31%
Tricare $1,095 90%
Blue Cross Blue Shield $1,134 - $1,421 93%
Humana $1,134 93%
Medicare (plans) $1,134 93%
Node Viva Mcr Adv $1,134 93%
UnitedHealthcare $1,134 - $3,200 93%
Select Health $1,146 94%
Compassionate Hands $1,153 94%
Covenant Hospice $1,153 94%
Dayspring Hospice $1,153 94%
Node Champva $1,153 94%
Node Hospice Non Par $1,153 94%
Node Va $1,153 94%
Southern Care Hospice $1,153 94%
Vistacare Hospice $1,153 94%
Wiregrass Hospice $1,153 94%
Care Improvement Plus $1,157 95%
Cigna $1,157 - $1,882 95%
Node Devoted Health Mcr Adv $1,157 95%
Node Clover Health Mcr Adv $1,164 95%
Aetna $1,168 - $23,417 96%
Node Wellcare Mcr Adv $1,176 96%
Eon Health Care $1,191 97%
Prime Health $1,214 - $22,631 99%
Node Us Dept Of Labor $1,441 118%
Ambetter / Centene $1,729 141%
Occunet $2,017 165%
Self Pay $4,812 394%
Viva Health $5,219 427%
Multiplan $5,578 - $25,662 456%
S & S Healthcare $8,019 656%
Choicecare Commercial $11,227 918%
American Employee Alliance $12,831 1050%
Coventry Healthcare $16,039 - $24,495 1312%
Standard Textile $22,455 1837%
Alamed Wc $22,631 1851%
Health Choice $23,417 1915%
Equian $24,058 - $25,293 1968%
Qhp $24,058 1968%
Novanet $25,662 2099%
Alabama Work Comp $26,625 2178%
Ccn/Mednet Ppo $27,266 2230%
Corvel $27,266 2230%
Industry Buying Group $27,266 2230%
Galaxy Health $28,870 2361%
Health Payors Org $28,870 2361%
National Provider Net $28,870 2361%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4370 West Main Street, Dothan, AL 36302
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals