CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Boulder Community Health

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,459
  • Cash Discount Price: $1,824
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Boulder Community Health is $1,459. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,824. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.19x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$1,824

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,459

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: $1,824 (149%)
Insurance Median: $1,459 (119%)
Cash: $1,824 (149% of Medicare)
Ins. Median: $1,459 (119% 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

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
UnitedHealthcare $194 - $1,218 16%
Humana $196 - $1,185 16%
Medicaid / KanCare $264 22%
Rocky Mountain Health Maintenance Organization $264 - $1,220 22%
Colorado Access $290 - $519 24%
Beech Street Community Medical Associates $302 25%
Multiplan $315 - $2,553 26%
Phcs $315 - $2,553 26%
Cigna $318 - $4,092 26%
Aetna $392 - $3,176 32%
Blue Cross Blue Shield $428 - $4,477 35%
Devoted Health $428 - $1,459 35%
Health Spring $428 - $1,185 35%
Medicare (plans) $428 - $1,386 35%
Clear Spring $441 - $1,220 36%
Select Health Colorado Public Option $599 - $2,607 49%
Select Health Value Network $599 - $2,761 49%
Kaiser Ppo $659 - $5,858 54%
Kaiser Public Option $659 - $4,905 54%
Rocky Mountain Health Maintenance Organization Private Plan $2,553 209%
Integrated Health Plans Bch $2,735 224%
Casualty Management Network, Prime Health Services Behavioral Health $3,100 254%
Mines And Associates $3,100 254%
Three Rivers Provider Network $3,100 254%
Zelis (Profee) $3,100 254%
Casualty Management Network, Prime Health Services Community Medical Associates $3,282 268%
National Preferred Provider Network $3,282 268%
Rockport Healthcare Group Community Medical Associates $3,282 268%
Usa $3,282 268%
Rockport Healthcare Group Bch $3,392 277%
Health Payors Organization $3,465 283%
Health Management Network Bch Community Medical Associates $3,501 286%
Health Management Network Community Medical Associates $3,501 286%
National Provider Network $3,538 289%
Kaiser $5,830 477%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals