CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Kingman Regional Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $666
Cash Discount Price: $532
vs. Medicare Baseline: 0.54x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Kingman Regional Medical Center is $666. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $532. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.54x the Medicare baseline. Located in 3269 Stockton Hill Road, Kingman, AZ.

Cash / Self-Pay

$532

Average discount available for prompt cash payment at this facility.

Insurance Median

$666

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: $532 (44%)

Insurance Median: $666 (54%)

Cash: $532 (44% of Medicare)

Ins. Median: $666 (54% 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
Health Choice Generations	$174	14%
Hpn Sierra Nevada Mcr Adv	$174	14%
Medicare (plans)	$174	14%
Triwest - All Plans	$174	14%
Care 1St Mcr Adv-All Other Plans	$183	15%
Mercy Care Adv Snp-All Other Plans	$192	16%
Humana	$195 - $641	16%
UnitedHealthcare	$224 - $691	18%
Geo Group Chc Az State Prison-All Plans	$261	21%
Aetna	$270	22%
Health Plan Of Nevada-All Other Plans	$270	22%
Health Choice Hie Exchange	$296	24%
Multiplan-All Plans	$296	24%
Blue Cross Blue Shield	$373	31%
Health Choice- All Other Plans	$435	36%
Apipa - Ahcccs-All Other Plans	$437	36%
Health Choice Az	$437	36%
Care 1St Mcaid	$459	38%
Mercy Care Ahcccs Ddd	$481	39%
Cigna	$753	62%
Three Rivers-All Plans	$1,147 - $1,530	94%
America'S Choice Provider Network-All Plans	$1,185 - $1,580	97%
Az Foundation-All Plans	$1,247 - $1,663	102%
Mediversal-All Plans	$1,247 - $1,663	102%
One Health Plan-All Plans	$1,247 - $1,663	102%
Universal Health-All Plans	$1,247 - $1,663	102%

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 $532.
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 Kingman 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.