CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Northwest Medical Center Sahuarita

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,282
  • Cash Discount Price: $3,060
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Northwest Medical Center Sahuarita is $1,282. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,060. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.05x the Medicare baseline. Located in 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ.
Cash / Self-Pay
$3,060

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,282

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: $3,060 (250%)
Insurance Median: $1,282 (105%)
Cash: $3,060 (250% of Medicare)
Ins. Median: $1,282 (105% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $744 - $796 61%
Mercy Care $744 - $1,256 61%
Aetna $1,256 - $2,736 103%
Blue Cross Blue Shield $1,256 - $3,608 103%
Cigna $1,256 - $3,883 103%
Humana $1,256 103%
Medicare (plans) $1,256 103%
Node Caremore Mcr Adv $1,256 103%
Node Mercy Care Mcr Adv $1,256 103%
UnitedHealthcare $1,256 - $2,517 103%
Department Of Veterans Affairs $1,277 104%
Node Champva $1,277 104%
Node Non Par Hospice Agree $1,277 104%
Node Triwest $1,277 - $1,368 104%
Node Va $1,277 104%
Tricare $1,277 104%
Node Clover Health Mcr Adv $1,290 106%
Node Devoted Health Mcr Adv $1,294 106%
Banner Mcr Adv $1,319 108%
Node Banner Mcr Adv $1,319 108%
Node Wellcare Mcr Adv $1,319 108%
Node Us Dept Of Labor $1,596 131%
Ambetter / Centene $1,800 147%
Node Health Choice Health Exchange $1,903 156%
Node Fusion Network $2,298 188%
Node J Allen Inmate Health Svcs $2,426 198%
Self Pay $3,060 250%
Coventry Work Comp Al $10,199 834%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ 85629
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals