CMS Price Transparency Data
Colonoscopy with biopsy
Facility: Whittier Hospital Medical Center
Billing Code: 45380 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45380
- Insurance Median: $1,514
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Whittier Hospital Medical Center is $1,514. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.24x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,514
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%)
Insurance Median: $1,514 (124%)
Ins. Median: $1,514 (124% 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 |
|---|---|---|
| Applecare Medical Group | $224 | 18% |
| Ahmc Medi-Cal Reciprocity Agreement | $330 | 27% |
| Aids Healthcare Foundation | $330 - $1,514 | 27% |
| Allied Physicians | $330 - $2,309 | 27% |
| Alta Med Health Network | $330 - $1,514 | 27% |
| Altamed Health Services Corporation | $330 | 27% |
| Beverly Hospital | $330 - $1,693 | 27% |
| Brand New Day | $330 - $1,893 | 27% |
| Emanate Health | $330 - $1,892 | 27% |
| Health Net | $330 - $1,514 | 27% |
| Healthy Way La | $330 | 27% |
| Heritage Provider Network | $330 - $2,078 | 27% |
| Kaiser Foundation | $330 - $5,387 | 27% |
| La Care Healthy Families/Healthy Kids | $330 | 27% |
| Non Contracted Medi-Cal | $330 | 27% |
| Prospect Health Plan | $330 - $2,463 | 27% |
| Synermed | $330 - $1,539 | 27% |
| La Care Health Plan | $380 - $1,514 | 31% |
| Monarch Healthplan | $462 | 38% |
| Avanti | $474 - $1,847 | 39% |
| Care First Health Plan | $474 | 39% |
| County Of Los Angeles Dept Of Health Services | $474 | 39% |
| Hollywood Presbyterian Adv Med Mcal | $474 | 39% |
| Hollywood Presbyterian Medpoint Mcal | $474 | 39% |
| Medi Caid/ Medi Cal | $474 | 39% |
| Central Health Plan Of California | $477 | 39% |
| Pacific Independent Physician Association | $500 - $1,400 | 41% |
| Aetna | $572 - $2,196 | 47% |
| Medicare (plans) | $635 - $1,590 | 52% |
| Prospect Medical | $700 | 57% |
| UnitedHealthcare | $709 - $3,700 | 58% |
| Davita Healthcare Partners | $820 | 67% |
| Molina Medical Center | $858 - $1,924 | 70% |
| Veterans Administration | $1,077 | 88% |
| Universal Care | $1,100 - $32,500 | 90% |
| Blue Cross Blue Shield | $1,495 - $3,129 | 122% |
| Alta Los Angeles Hospitals Inc | $1,514 | 124% |
| Apa/Aco Inc | $1,514 | 124% |
| Caloptima | $1,514 | 124% |
| Central Health Plan | $1,514 | 124% |
| Easy Choice Health Plan | $1,514 | 124% |
| Humana | $1,514 | 124% |
| Pacificare Of California | $1,514 | 124% |
| Scan Health Plan | $1,514 | 124% |
| Blue Shield Of California | $1,539 - $1,992 | 126% |
| Caremore | $1,539 | 126% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $1,539 | 126% |
| La Care Covered Direct | $1,539 | 126% |
| Pacific Alliance Medical Center | $1,539 | 126% |
| Private Pay | $1,539 | 126% |
| Self-Pay | $1,539 | 126% |
| Alignment Health Plan | $1,590 | 130% |
| Molina Healthcare Of California | $1,590 | 130% |
| San Miguel Health Plan | $1,693 | 138% |
| Chinatown Service Center Pace | $1,847 | 151% |
| Ahmc Health | $1,924 | 157% |
| Knox-Keene Act | $1,924 | 157% |
| Fmc Los Angeles County | $1,945 | 159% |
| Interplan Health Group | $1,986 | 162% |
| Capnet | $2,000 | 164% |
| Edward Medical Group | $2,000 | 164% |
| Athens Administrators Ahmc Work Comp | $2,047 | 167% |
| Misc 1 | $2,047 | 167% |
| Multiplan Wc | $2,047 | 167% |
| Great-West Healthcare Of California | $2,500 | 204% |
| Prohealth | $2,500 | 204% |
| Care 1St Health Plan | $2,600 - $5,500 | 213% |
| Cost Containment | $2,800 | 229% |
| Health Net Inc | $3,774 - $3,954 | 309% |
| Healthnet | $4,619 | 378% |
| Tricare | $4,917 | 402% |