CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Sharp Chula Vista Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,223
Cash Discount Price: $2,756
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Sharp Chula Vista Medical Center is $2,223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,756. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.82x the Medicare baseline. Located in 751 Medical Center Court, Chula Vista, CA.

Cash / Self-Pay

$2,756

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,223

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: $2,756 (225%)

Insurance Median: $2,223 (182%)

Cash: $2,756 (225% of Medicare)

Ins. Median: $2,223 (182% 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
Health Net	$1,029 - $2,572	84%
Blue Shield	$1,091 - $2,756	89%
Indian Health Council	$1,091 - $1,764	89%
Medicare (plans)	$1,091 - $2,076	89%
Molina	$1,091 - $2,297	89%
Aetna	$1,443 - $3,602	118%
Blue Cross Blue Shield	$1,838 - $2,940	150%
County Medical Services	$2,076	170%
Cigna	$2,242	183%
Kaiser	$2,297	188%
Multiplan	$2,297	188%
Epic Americas	$2,315	189%
California Health And Wellness	$2,334 - $2,572	191%
Community Health Group	$2,334 - $2,572	191%
San Diego Pace	$2,481	203%
UnitedHealthcare	$2,572	210%
Humana	$2,756	225%

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 $2,756.
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 Sharp Chula Vista 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.