CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Alameda Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,701
Cash Discount Price: $2,926
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Alameda Hospital is $1,701. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,926. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.39x the Medicare baseline. Located in 2070 Clinton Avenue, Alameda, CA.

Cash / Self-Pay

$2,926

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,701

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: $2,926 (239%)

Insurance Median: $1,701 (139%)

Cash: $2,926 (239% of Medicare)

Ins. Median: $1,701 (139% 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	$288 - $3,646	24%
Kaiser Medi-Cal Managed Care [1026106]	$330	27%
Aetna	$811 - $1,701	66%
Alameda Alliance Commercial Alternate [4801]	$914	75%
Alameda Alliance Mgd Mcal Alternate [2801]	$914	75%
Alameda Alliance Non-Verified [1002303]	$914	75%
Alameda Alliance [1002106]	$914	75%
Alameda Alliance [1002206]	$914	75%
Mc Alameda Alliance Capitation [1002103]	$914	75%
Brown Toland Medical Group Alternate [1049301]	$1,701	139%
Brown Toland Medical Group [1049001]	$1,701	139%
Brown Toland Mgd Mcr Alternate [1802]	$1,701	139%
Medicare (plans)	$1,701	139%
UnitedHealthcare	$2,113 - $2,415	173%
Blue Shield [1006001]	$3,096 - $3,646	253%
Kaiser Commercial [1026001]	$3,804	311%
Cigna	$4,214	345%
Health Net [1022001]	$4,679	383%

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 $2,926.
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 Alameda 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.