CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Phoenix Children's Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,441
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Phoenix Children's Hospital is $1,441. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.18x the Medicare baseline. Located in 1919 East Thomas Road, Phoenix, AZ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,441

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%)
Insurance Median: $1,441 (118%)
Ins. Median: $1,441 (118% 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
Ahc Lcd $246 20%
Ahccs $439 - $789 36%
Ahc Apipa $447 37%
Ahc Care First $447 37%
Ahc Cmdp $447 37%
Ahc Crs $447 37%
Ahc Ihs $447 37%
Ahc Mercy Care $447 37%
Ahc University $493 40%
Ahc Healthchoice $714 58%
Healthcomp $1,441 118%
Intel $1,441 118%
UnitedHealthcare $1,567 - $5,822 128%
Aetna $1,650 - $2,640 135%
Antidote $2,341 191%
Cigna $2,507 - $7,971 205%
Multiplan $2,882 236%
Blue Cross Blue Shield $3,602 - $4,100 295%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1919 East Thomas Road, Phoenix, AZ 85016
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens