CMS Price Transparency Data
Colonoscopy with biopsy
Facility: Menifee Global Medical Center
Billing Code: 45380 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45380
- Insurance Median: $1,878
- Cash Discount Price: $5,364
- vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Menifee Global Medical Center is $1,878. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,364. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.54x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
$5,364
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,878
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: $5,364 (439%)
Insurance Median: $1,878 (154%)
Cash: $5,364 (439% of Medicare)
Ins. Median: $1,878 (154% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Lasalle Medical Assoc (Ancillary) Mcal Hmo | $390 | 32% |
| Tricare | $437 - $4,721 | 36% |
| Health Net Medi-Cal | $474 - $14,700 | 39% |
| Ic | $474 - $5,364 | 39% |
| Kaiser Medi-Cal | $474 | 39% |
| Prospect Health Plan Mcal Hmo | $488 | 40% |
| Blue Cross Blue Shield | $497 | 41% |
| Molina Medi-Cal | $559 - $15,000 | 46% |
| Altamed Mcal Hmo | $663 - $15,000 | 54% |
| Altamed Mcal/Pace | $663 - $15,000 | 54% |
| Iehp Medi-Cal | $711 | 58% |
| Health Net Enhanced Ppo | $719 - $2,144 | 59% |
| Molina Covered Ca | $1,510 - $4,626 | 124% |
| Aetna | $1,532 - $3,224 | 125% |
| Altamed Comm Hmo (Ancillary) | $1,532 - $5,364 | 125% |
| Altamed Health Services Senior | $1,532 | 125% |
| Altamed Sr/Pace | $1,532 | 125% |
| Blue Shield Senior | $1,532 | 125% |
| Central Health Plan Senior | $1,532 | 125% |
| Clever Care Health Plan Sr | $1,532 | 125% |
| For Your Benefit Senior | $1,532 | 125% |
| Guidant Health Plan Senior | $1,532 | 125% |
| Health Net Senior | $1,532 | 125% |
| Hpn Senior | $1,532 | 125% |
| Humana | $1,532 | 125% |
| Kaiser Senior | $1,532 | 125% |
| Lasalle Medical Assoc (Ancillary) Senior | $1,532 | 125% |
| Managed Health Network Sr | $1,532 | 125% |
| Medicare (plans) | $1,532 | 125% |
| Neighborhood Healthcare Pace | $1,532 | 125% |
| Primecare Senior | $1,532 | 125% |
| Prospect Health Plan Sr Hmo | $1,532 | 125% |
| Scan Senior | $1,532 | 125% |
| Sr Capitation | $1,532 | 125% |
| UnitedHealthcare | $1,532 - $2,212 | 125% |
| Veterans Administration | $1,532 | 125% |
| Imperial Health Plan Of Ca | $1,539 | 126% |
| Lasalle Medical Assoc (Ancillary) Commercial | $1,539 | 126% |
| Point Comfort Underwriters | $1,539 | 126% |
| Self Pay/Ab774/Charity Discount | $1,539 | 126% |
| Cigna | $1,699 - $4,291 | 139% |
| Align Senior Care | $1,715 | 140% |
| Welbehealth Sr/Pace | $1,715 | 140% |
| Prime Health Services Senior | $1,761 | 144% |
| Coventry | $1,842 - $1,914 | 151% |
| Prime Health Services Wcomp | $1,842 | 151% |
| Iehp Covered Ca | $1,914 | 157% |
| Three Rivers Wcomp | $2,006 | 164% |
| Workers Comp Non-Contracted | $2,047 | 167% |
| Prospect Health Plan Comm Hmo | $2,068 | 169% |
| Hpn Commercial/Covered Ca | $2,144 | 175% |
| Health Net Comm | $2,297 | 188% |
| Velocity | $2,414 - $2,693 | 197% |
| Three Rivers Network | $2,693 | 220% |
| First Health Commercial | $2,816 | 230% |
| Hpn Mcal | $2,950 | 241% |
| Choice Physicians Network | $3,487 - $5,200 | 285% |
| Primecare Commercial | $3,487 | 285% |
| Multiplan Ppo | $3,755 | 307% |
| Multiplan Wcomp | $3,755 | 307% |
| Pnoa-Provider Network Of America | $4,291 | 351% |
| Prime Health Services Commercial | $4,291 | 351% |
| Blue Shield Epn | $4,304 | 352% |
| Blue Shield Commercial | $5,069 | 415% |
| Ava Hospice | $5,364 | 439% |
| Kaiser Commercial | $5,364 | 439% |
| Living Waters Hospice | $5,364 | 439% |
| Managed Health Network | $5,364 | 439% |
| Other Insurance Loa | $5,364 | 439% |
| Pacific Valley Hospice | $5,364 | 439% |
| Private Pay | $5,364 | 439% |
| Silverado Hospice | $5,364 | 439% |
| Vna Hospice | $5,364 | 439% |