CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Anaheim Global Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $4,691
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 3.84x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Anaheim Global Medical Center is $4,691. 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 3.84x the Medicare baseline. Located in 1025 S Anaheim Blvd, Anaheim, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,691

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: $4,691 (384%)
Ins. Median: $4,691 (384% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 384% of the Medicare baseline (a markup of 284%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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
Medi-Cal Hmo/Non Contract $330 27%
Brand New Day $396 - $5,865 32%
Healthcare Partners $474 39%
Hollywood Presbyterian $474 39%
Kaiser $474 - $4,691 39%
Prime Health Services $474 - $5,395 39%
State Of California $474 - $2,047 39%
Altamed $663 - $4,691 54%
Caloptima $663 - $4,692 54%
Choc Health Alliance $663 54%
County Of Orange $663 - $5,864 54%
Family Choice Mcal $663 54%
Heritage Provider Network $663 - $4,691 54%
Prospect Health Plan $663 - $7,039 54%
Ihhi Reciprocity $1,200 98%
Coventry Health $1,842 - $1,914 151%
Interplan $1,863 152%
Multiplan $2,006 - $35,000 164%
Three Rivers Network $2,006 - $8,212 164%
Velocity National Provider Network Wc $2,047 167%
Aetna $2,138 - $4,691 175%
Monarch Health Plan $3,591 - $4,519 294%
Altamed Health Services $4,457 - $4,691 365%
UnitedHealthcare $4,605 - $4,764 377%
Astiva $4,691 384%
Blue Shield Of California $4,691 - $17,874 384%
California Health Plan $4,691 384%
Central Health Plan Of California Inc $4,691 384%
Champion Health Plan $4,691 384%
Citizens Choice $4,691 384%
Clever Care Health Plan $4,691 384%
Easy Choice $4,691 384%
For Your Benefit $4,691 384%
Health Net Inc $4,691 384%
Healthcare Partners Sr Hmo $4,691 384%
Hollywood Presbyerian $4,691 384%
Humana $4,691 384%
Medicare (plans) $4,691 384%
Monarch $4,691 384%
Onecare $4,691 384%
Other Sr Non Contract $4,691 384%
Physicians For Healthy Hospitals $4,691 384%
Scan $4,691 384%
St Joseph Hospital Sr $4,691 384%
Us Federal Marshall/Department Of Immigration $4,691 384%
Velocity National Provider Network Sr $4,691 384%
Verda Health Plan $4,691 384%
Veterans Administration $4,691 384%
Choice Physicians Network $4,692 384%
Imperial Health Plan Of Ca $4,692 384%
Innovative Integrated Health $4,692 384%
Medcare Partners Health Plan $4,692 384%
Self Pay/Ab774/Cbo Use Only $4,692 384%
Us Dept Of Labor $4,692 384%
Victim Of Violent Crime $4,692 384%
Victim Of Violent Crime (Mep) $4,692 384%
Victoria Hospice $4,692 384%
Champus $4,721 386%
Healthcare Partners Hmo $5,068 415%
Align Sr Care $5,254 430%
Veterans Evaluation Services $5,865 480%
Cigna $5,871 480%
Staywell/Island Home Ins $6,569 537%
Health Net $6,616 - $8,088 541%
Naphcare $7,273 595%
Healthsmart Preferred Network $37,500 3067%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1025 S Anaheim Blvd, Anaheim, CA 92805
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals