CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Oro Valley Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,458
  • Cash Discount Price: $4,579
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Oro Valley Hospital is $1,458. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,579. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.19x the Medicare baseline. Located in 1551 East Tangerine Road, Oro Valley, AZ.
Cash / Self-Pay
$4,579

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,458

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: $4,579 (375%)
Insurance Median: $1,458 (119%)
Cash: $4,579 (375% of Medicare)
Ins. Median: $1,458 (119% 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 $405 33%
Medicaid / KanCare $744 - $796 61%
Magellan $781 - $11,449 64%
Aetna $1,256 - $3,625 103%
Caremore Health Plan $1,256 103%
Cigna $1,256 - $3,883 103%
Humana $1,256 103%
Medicare (plans) $1,256 103%
Scan Health $1,256 103%
UnitedHealthcare $1,256 - $2,517 103%
Pascua Yaqui Tribe $1,264 103%
Blue Cross Blue Shield $1,277 - $3,608 104%
Department Of Veterans Affairs $1,277 104%
Node Non Par Hospice Agree $1,277 104%
Node Triwest $1,277 104%
Node Va $1,277 104%
Tricare $1,277 104%
Fresenius Health $1,282 105%
Clover Health Mcr Adv $1,290 106%
Node Devoted Health Mcr Adv $1,294 106%
Node Banner Mcr Adv $1,319 108%
Wellcare Mcr Adv $1,319 108%
Node Us Dept Of Labor $1,596 131%
Ambetter / Centene $1,800 147%
Node Health Choice Exchange $1,903 156%
Node Fusion Network $2,298 188%
Node J Allen Inmate Health Svcs $2,426 198%
Health Net $2,682 219%
Seven Corners $2,937 240%
Self Pay $4,579 375%
Beacon Health Options $9,541 780%
Mtc $9,541 780%
First Health Coventry $10,018 819%
Coventry Work Comp Al $11,449 936%
Multiplan $15,837 1295%
Prime Health $16,219 1327%
Three Rivers $16,219 1327%
Healthsmart $17,173 1405%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1551 East Tangerine Road, Oro Valley, AZ 85755
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals