CMS Price Transparency Data
Colonoscopy with biopsy
Facility: John Muir Behavioral Health Center
Billing Code: 45380 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 45380
- Insurance Median: $1,967
- Cash Discount Price: $2,012
- vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at John Muir Behavioral Health Center is $1,967. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,012. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.61x the Medicare baseline. Located in 2740 Grant Street, Concord, CA.
Cash / Self-Pay
$2,012
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,967
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: $2,012 (165%)
Insurance Median: $1,967 (161%)
Cash: $2,012 (165% of Medicare)
Ins. Median: $1,967 (161% 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 |
|---|---|---|
| Alignment Health [1177113] | $1,690 | 138% |
| Blue Cross Blue Shield | $1,690 - $4,552 | 138% |
| Care 1St Health Plan [1094113] | $1,690 | 138% |
| Caremore [1171113] | $1,690 | 138% |
| Essence Healthcare [1049128] | $1,690 | 138% |
| Medicare (plans) | $1,690 - $1,760 | 138% |
| Aetna | $1,760 - $2,683 | 144% |
| Blue Shield-Network Mcare [1006127] | $1,760 | 144% |
| Easy Choice Health Plan [1083113] | $1,760 | 144% |
| Golden State-Network Mcare [1023127] | $1,760 | 144% |
| Humana | $1,760 - $1,967 | 144% |
| Scan-Network Mcare [1043127] | $1,760 | 144% |
| UnitedHealthcare | $1,760 | 144% |
| Veterans Administration [1051113] | $1,760 | 144% |
| Contra Costa County Jail [1012104] | $1,967 | 161% |
| Federal Correction Institute [1062104] | $1,967 | 161% |
| Fortified Provider Network [1063104] | $1,967 | 161% |
| Galaxy Health Network [1064104] | $1,967 | 161% |
| Health Management Network [1066104] | $1,967 | 161% |
| Healthsmart - Pka Interplan [1031104] | $1,967 | 161% |
| Hospice Of East Bay [1085104] | $1,967 | 161% |
| Integrated Health Plan [1075104] | $1,967 | 161% |
| Medigap [1036001] | $1,967 | 161% |
| National Provider Network/Plancare America [1069104] | $1,967 | 161% |
| Networks By Design [1084104] | $1,967 | 161% |
| Pponext [1072104] | $1,967 | 161% |
| Sutter Preferred Health Plan [1044104] | $1,967 | 161% |
| Three Rivers Provider Network [1073104] | $1,967 | 161% |
| Generic Commercial/Indemnity [1017001] | $2,112 - $3,309 | 173% |
| Generic Hmo [1018103] | $2,112 | 173% |
| Generic Ppo [1021104] | $2,112 | 173% |
| Blue Shield Hmo [1006103] | $2,151 | 176% |
| Blue Shield Ppo [1006104] | $2,151 | 176% |
| Blue Shield-Network [1006026] | $2,151 | 176% |
| Carelon Behavioral Health [1050104] | $2,459 | 201% |
| Health Net Hmo [1028103] | $2,459 | 201% |
| Health Net Ppo [1028104] | $2,459 | 201% |
| Health Net-Network [1028026] | $2,459 | 201% |
| Aps Healthcare [1003103] | $2,683 | 219% |
| Brms [1091104] | $2,683 | 219% |
| Delta Health Systems [1032104] | $2,683 | 219% |
| Empire Plan [1092104] | $2,683 | 219% |
| Healthcomp [1089104] | $2,683 | 219% |
| Kaiser Hmo [1033103] | $2,683 | 219% |
| Carecentrix [1011001] | $3,309 | 271% |
| Donor Network West [1008103] | $3,309 | 271% |
| Western Health Advantage Hmo [1053103] | $3,309 | 271% |
| Cigna | $3,353 | 274% |
| Beacon Health Strategies [1005103] | $3,577 | 293% |