CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Adventist Health Reedley

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $330
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 0.27x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Adventist Health Reedley is $330. 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 0.27x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$330

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: $330 (27%)
Cash: $129 (11% of Medicare)
Ins. Median: $330 (27% 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
Healthnet Medi-Cal $102 8%
Blue Shield Mcare $178 - $1,539 15%
Fhcn Pace Mcr Adv-All Plans $178 - $1,539 15%
Lasalle Med Assoc Profee Only - All Plans $178 15%
Sante Ipa Mcal/Mcare Hmo Profee Only $178 15%
Tricare $178 - $1,539 15%
UnitedHealthcare $178 - $8,266 15%
Upn Mcr Adv Profee Only $178 15%
Ah Employee Health Plan - All Plans $196 - $2,770 16%
Community Care Ipa Mcal-All Plans $213 - $429 17%
Sante Ipa Hmo Profee Only - All Other Plans $213 17%
Aetna $232 - $10,039 19%
Cigna $235 - $440 19%
Kaiser - All Other Plans $240 - $338 20%
Kaiser Mcr Adv $240 - $1,539 20%
Western Growers/Pinnacle- All Plans $247 - $10,215 20%
Healthnet- All Other Plans $259 - $294 21%
Cal Viva Hlth Mcal - All Plans $330 27%
Kern Health Systems Mcal-All Plans $330 27%
Medi-Cal $330 27%
Dignity Mcal Op/Profee Only-All Other Plans $363 30%
Blue Shield Epn - All Other Plans $367 - $703 30%
Blue Shield Non Epn $423 - $743 35%
Physicians Med Group Op/Profee Only- All Plans $542 44%
Bc Mcal $638 52%
Blue Cross Blue Shield $769 - $6,903 63%
Dignity Mcr Adv Op/Profee Only $1,539 126%
Healthnet- Mcr Adv $1,539 126%
Phs Prime Health Srvcs $1,539 126%
Bright Health Mcr Adv - All Plans $2,416 198%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 372 W Cypress Ave, Reedley, CA 93654
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals