CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Memorial Care Miller Children's & Women's Hosp Lb

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $3,398
Cash Discount Price: $6,270
vs. Medicare Baseline: 2.78x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Memorial Care Miller Children's & Women's Hosp Lb is $3,398. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,270. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 2.78x the Medicare baseline. Located in 2801 Atlantic Avenue, Long Beach, CA.

Cash / Self-Pay

$6,270

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,398

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: $6,270 (513%)

Insurance Median: $3,398 (278%)

Cash: $6,270 (513% of Medicare)

Ins. Median: $3,398 (278% 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 278% of the Medicare baseline (a markup of 178%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Select Health	$1,000	82%
Heritage Provider Network	$1,400	115%
Monarch Health Plan	$1,462 - $4,079	120%
Caremore	$1,539	126%
Blue Cross Blue Shield	$1,612 - $4,370	132%
Aetna	$1,714 - $2,947	140%
Global Care Medical Group	$1,847	151%
Healthcare Partners	$1,924 - $4,186	157%
Cigna	$2,167 - $3,448	177%
Molina	$2,493	204%
UnitedHealthcare	$3,398 - $5,830	278%
Centivo	$3,463	283%
Healthnet	$3,747 - $5,353	306%
Blue Shield	$5,649 - $9,049	462%

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 $6,270.
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 Memorial Care Miller Children's & Women's Hosp Lb 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.