CMS Price Transparency Data
Colonoscopy with biopsy
Facility: Children's Hosp of Los Angeles
Billing Code: 45380 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45380
- Insurance Median: $971
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.79x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Children's Hosp of Los Angeles is $971. 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 0.79x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$971
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: $971 (79%)
Ins. Median: $971 (79% 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 |
|---|---|---|
| Altamed | $462 - $14,796 | 38% |
| Caloptima | $462 | 38% |
| Medi-Cal | $474 | 39% |
| Valley Presbyterian Hospital | $474 | 39% |
| Choc Health Alliance | $592 | 48% |
| Health Net | $592 | 48% |
| St Francis Medical Center | $616 - $914 | 50% |
| Bella Vista Med Grp | $692 | 57% |
| Centinela Valley Ipa | $692 | 57% |
| El Proyecto Del Barrio | $692 | 57% |
| Global Care Medical Group | $692 | 57% |
| Health Care La Ipa | $692 | 57% |
| Premier Physicians Ntwk | $692 | 57% |
| Watts Healthcare Mmc | $692 | 57% |
| Community Family Care Ipa | $711 | 58% |
| Hollywood Presbyterian Medical Center | $711 | 58% |
| Heritage Provider Network | $758 - $17,217 | 62% |
| Blue Cross Blue Shield | $781 - $2,416 | 64% |
| La Care | $786 - $15,065 | 64% |
| Serra Community Med Clinic | $812 | 66% |
| Care 1St | $829 | 68% |
| White Memorial Medical Center | $829 | 68% |
| Adventist Health Physicians | $853 - $16,141 | 70% |
| Cal Care Ipa | $862 | 71% |
| Associated Hispanic Physicians Ipa | $876 | 72% |
| Gold Coast Health Plan | $876 | 72% |
| Hispanic Physician Ipa | $876 | 72% |
| Serendib Healthways Mmc | $876 | 72% |
| Beverly Hospital | $881 | 72% |
| Los Angeles Medical Center Ipa | $886 | 72% |
| San Judas Med Grp | $886 | 72% |
| Alhambra Hospital Medical Center | $891 | 73% |
| Accountable Health | $905 | 74% |
| Souther California Hosp System - Mmc | $908 | 74% |
| Cencal Health | $914 | 75% |
| Pacific Alliance Medical Center | $928 | 76% |
| Blue Shield | $937 - $4,242 | 77% |
| Angeles Ipa | $947 | 77% |
| Crown City Medical Group | $947 | 77% |
| Employee Health Systems Med Grp | $947 | 77% |
| Point Comfort Underwriters | $947 | 77% |
| Seaside Health Plan | $947 | 77% |
| Imperial Health Holdings Medical Group | $966 | 79% |
| Karing Physicians Medical Group | $966 | 79% |
| Noble Community Medical Associates | $966 | 79% |
| Regent Medical Group | $966 | 79% |
| Avalon Ipa | $971 | 79% |
| Exceptional Care Medical Group | $971 - $20,535 | 79% |
| Mabuhay Medical Group | $971 | 79% |
| Preferred Ipa | $971 | 79% |
| Primary Care And Pediatric Ipa | $971 | 79% |
| Inland Empire Health Plan | $976 | 80% |
| Family Care Specialists | $999 | 82% |
| Molina | $999 | 82% |
| Family Health Alliance Med Grp | $1,018 | 83% |
| Applecare Medical Group | $1,047 - $17,486 | 86% |
| Community Care Ipa Mmc | $1,047 | 86% |
| Dignity Health | $1,052 | 86% |
| Allied Pacific Ipa | $1,113 | 91% |
| Asian Community Medical Group | $1,127 | 92% |
| California Pacific Physicians Medical Group | $1,127 | 92% |
| Healthy New Life Medical Corp | $1,127 | 92% |
| Kern Family Health Plan | $1,194 | 98% |
| Superior Choice Medical Group | $1,284 | 105% |
| Southland San Gabriel Valley Medical Group | $1,293 | 106% |
| Cigna | $3,495 | 286% |
| Champus | $4,770 | 390% |
| UnitedHealthcare | $6,367 - $11,756 | 521% |
| Medicare (plans) | $8,794 | 719% |
| Accarent Health | $8,967 | 733% |
| Sierra Health And Life Insurance Company | $10,000 | 818% |
| Delta Health Systems | $11,564 | 946% |
| Incentive Health Network | $16,590 | 1357% |
| Gemcare Ipa | $17,217 | 1408% |
| Managed Care Systems | $17,486 | 1430% |
| Providence Health Network | $17,935 | 1467% |
| Ventura County Health Plan | $22,867 | 1870% |
| Good Samaritan Medical Group | $24,660 | 2017% |
| Access Medical Group | $24,929 | 2039% |
| Staywell Insurance | $25,000 | 2045% |
| Seoul Medical Group | $27,530 | 2252% |
| Southern Atlantic Medical Group Mmc | $30,594 | 2502% |