CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Adventist Health Bakersfield

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $233
Cash Discount Price: $102
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Adventist Health Bakersfield is $233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.19x the Medicare baseline. Located in 2615 Chester Avenue, Bakersfield, CA.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$233

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: $102 (8%)

Insurance Median: $233 (19%)

Cash: $102 (8% of Medicare)

Ins. Median: $233 (19% 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
Kern Health Systems Mcal	$49	4%
Blue Shield Mcr Adv	$179	15%
Fhcn Pace Mcr Adv - All Plans	$179	15%
Gem Care- All Plans	$179	15%
Healthnet Mcr Adv	$179	15%
Kern Legacy Share Select	$179	15%
Oscar - All Plans	$179	15%
Premier Physician Alliance Profee Only-All Plans	$179	15%
UnitedHealthcare	$179 - $264	15%
County Of Kern - All Plans	$197	16%
Employee Health Plan - All Plans	$197	16%
Kern Legacy Hp Epo - All Other Plans	$197	16%
Network Provdrs Llc Mcare -All Payers	$233	19%
Aetna	$247	20%
Western Growers/Pinnacle- All Plans	$249	20%
Cigna	$254	21%
Healthnet Hmo/Pos/Ppo/Epo - All Other Plans	$261	21%
Centivo - All Plans	$268	22%
Blue Shield Epn	$703	58%
Blue Shield Epo/Ppo	$743	61%
Blue Shield Hmo/Pos - All Other Plans	$743	61%
Blue Cross Blue Shield	$793	65%
Universal Health Plan Mcare-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 $102.
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 Bakersfield 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.