CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Parkview Community Hospital Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,539
Cash Discount Price: $4,186
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Parkview Community Hospital Medical Center is $1,539. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,186. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.26x the Medicare baseline. Located in 3865 Jackson Street, Riverside, CA.

Cash / Self-Pay

$4,186

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,539

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: $4,186 (342%)

Insurance Median: $1,539 (126%)

Cash: $4,186 (342% of Medicare)

Ins. Median: $1,539 (126% 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	$474 - $2,527	39%
Blue Shield	$474 - $2,231	39%
Health Net	$474 - $2,394	39%
Medi-Cal	$474	39%
Molina Medi-Cal	$488	40%
Regal	$568 - $2,511	46%
UnitedHealthcare	$714 - $2,721	58%
Iehp	$1,231 - $1,969	101%
Central Health Plan	$1,364	112%
Humana	$1,484	121%
Alignment	$1,514	124%
Medicare (plans)	$1,514	124%
Aetna	$1,539 - $2,020	126%
Ahmc	$1,539	126%
Champus	$1,539	126%
Molina Covered Ca	$1,539	126%
Molina Senior	$1,539	126%
Scan	$1,539	126%
Cigna	$2,225	182%
Blue Shield Ppo	$2,231	182%
Self Pay	$4,186	342%

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 $4,186.
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 Parkview Community Hospital 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.