CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Adventist Health Lodi Memorial

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $472
  • Cash Discount Price: $65
  • vs. Medicare Baseline: 0.39x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Adventist Health Lodi Memorial is $472. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.39x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$65

Average discount available for prompt cash payment at this facility.

Insurance Median
$472

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: $65 (5%)
Insurance Median: $472 (39%)
Cash: $65 (5% of Medicare)
Ins. Median: $472 (39% 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
Medcore(Omni Ipa) Op Only- All Plans $129 - $505 11%
Blue Shield Epn - All Other Plans $161 - $703 13%
Blue Shield Non-Epn $167 - $743 14%
Alignment Health Plan (Ahp)-All Plans $178 - $1,578 15%
Blue Shield Mcare Adv $178 - $1,578 15%
Healthnet Mcare $178 - $1,578 15%
Hp Of San Joaquin Mcr Adv $178 - $1,578 15%
Humana $178 - $1,578 15%
Knnex Health - All Plans $178 - $1,894 15%
Tricare $178 - $1,578 15%
UnitedHealthcare $178 - $4,954 15%
Hp Healthy Kids Pro Fee $187 15%
Ah Employee Health Plan - All Plans $196 - $2,841 16%
Kaiser Commercial - All Other Plans $203 - $797 17%
First Health- All Plans $213 - $1,361 17%
Beech Street- All Plans $231 - $1,750 19%
Hp Of San Joaquin Ppo - All Other Plans $231 - $1,847 19%
Multiplan- All Plans $231 - $1,555 19%
Cigna $235 - $1,750 19%
Kaiser Mcr Adv $240 - $1,578 20%
Networks By Design- All Plans $240 - $972 20%
Healthnet- All Other Plans $244 - $955 20%
Western Growers- All Plans $254 - $1,555 21%
Kaiser Mcal $330 27%
Medi-Cal $330 27%
Aetna $336 - $16,197 27%
Blue Cross Blue Shield $358 - $1,561 29%
Hp Of San Joaquin Mcal $413 34%
Three Rivers Provider Network- All Plans $446 - $1,750 36%
Healthnet Mcal $472 39%
Celtic Ins Company - All Plans $496 - $522 41%
Bc Mcal $652 53%
Cca Health Plan Mcr Adv- All Plans $1,578 129%
Bright Health - All Plans $3,157 258%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals