CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Adventist Health Hanford

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $261
Cash Discount Price: $129
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Adventist Health Hanford is $261. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.21x the Medicare baseline. Located in 115 Mall Drive, Hanford, CA.

Cash / Self-Pay

$129

Average discount available for prompt cash payment at this facility.

Insurance Median

$261

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: $129 (11%)

Insurance Median: $261 (21%)

Cash: $129 (11% of Medicare)

Ins. Median: $261 (21% 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
Upn Mcal Profee	$169	14%
Blue Shield Mcr Adv	$178	15%
Fhcn Pace Mcr Adv-All Plans	$178	15%
Prime Health Mcr Adv- All Plans	$178	15%
Sante Ipa Mcal/Mcare Hmo Profee Only	$178	15%
Tricare	$178	15%
UnitedHealthcare	$178 - $264	15%
Central Valley Med Prov Profee Only-All Plans	$187	15%
Ah Employee Health Plan - All Plans	$196	16%
Sante Ipa Hmo Profee Only - All Other Plans	$213	17%
Aetna	$232	19%
Cigna	$235	19%
Kaiser - All Other Plans	$240	20%
Kaiser Mcr Adv	$240	20%
Western Growers/Pinnacle- All Plans	$247	20%
Healthnet - All Other Plans	$259	21%
Bc Mcal	$330	27%
Healthnet Mcal	$330	27%
Kaiser Mcal	$330	27%
Medi-Cal	$330	27%
Universal Hc Mcal Profee	$330	27%
Valley Childrens - All Plans	$555	45%
Blue Shield Epn	$703	58%
Blue Shield Non-Epn - All Other Plans	$743	61%
Blue Cross Blue Shield	$769	63%
Universal Hc Mcr Adv Profee - All Other Plans	$1,539	126%
Upn Mcr Adv Profee - All Other Plans	$1,539	126%

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 $129.
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 Adventist Health Hanford 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.