CMS Price Transparency Data

Colonoscopy with biopsy

Facility: White River Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,155
Cash Discount Price: $780
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at White River Medical Center is $1,155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $780. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.94x the Medicare baseline. Located in 1710 Harrison Street, Batesville, AR.

Cash / Self-Pay

$780

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,155

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: $780 (64%)

Insurance Median: $1,155 (94%)

Cash: $780 (64% of Medicare)

Ins. Median: $1,155 (94% 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.

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
Blue Cross Blue Shield	$100 - $1,155	8%
Aetna	$502 - $1,155	41%
Arkansas Total Care	$502	41%
Summit Community Care	$502	41%
Municipal Health Benefit Fund	$582	48%
Multiplan	$728	60%
Arkansas Superior Select Wrmc	$1,155	94%
Hmo Partners Inc Wrmc	$1,155	94%
Medipak Advantage Wrmc	$1,155	94%
UnitedHealthcare	$1,155	94%
Medicare (plans)	$1,178	96%
Cigna	$1,189	97%
Allwell Wrmc	$1,212	99%
Wellcare Wrmc	$1,212	99%
Ambetter / Centene	$1,616	132%
Qualchoice (Alliance) Wrmc	$1,769	145%
Provider Network Of America Wrmc	$1,847	151%
Vantage Health Plan Wrmc	$3,233	264%

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 $780.
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 White River 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.