CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Oroville Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $871
Cash Discount Price: $498
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Oroville Hospital is $871. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $498. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.71x the Medicare baseline. Located in 2767 Olive Highway, Oroville, CA.

Cash / Self-Pay

$498

Average discount available for prompt cash payment at this facility.

Insurance Median

$871

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: $498 (41%)

Insurance Median: $871 (71%)

Cash: $498 (41% of Medicare)

Ins. Median: $871 (71% 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	$269 - $1,095	22%
Butte County	$346	28%
Cigna	$796	65%
Coventry Health Care	$796	65%
Health Net	$796	65%
Multiplan	$796	65%
Interplan	$846	69%
Three Rivers Provider Network	$846	69%
UnitedHealthcare	$846 - $1,124	69%
Beech Street	$896	73%
Healthstar	$896	73%
Health Payors Organization	$945	77%
Blue Shield Of California	$965	79%
Aetna	$1,124	92%
Community Care	$1,124	92%
Nivano Physicians Inc	$1,124	92%
River City Medical Group	$1,237	101%
Blue Shield Value Network	$1,244	102%
Partnership Healthplan Of California	$1,855	152%

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 $498.
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 Oroville Hospital 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.