CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Longs Peak Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,025
Cash Discount Price: $2,014
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Longs Peak Hospital is $2,025. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,014. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.66x the Medicare baseline. Located in 1750 E Ken Pratt Blvd, Longmont, CO.

Cash / Self-Pay

$2,014

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,025

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: $2,014 (165%)

Insurance Median: $2,025 (166%)

Cash: $2,014 (165% of Medicare)

Ins. Median: $2,025 (166% 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.

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
Blue Cross Blue Shield	$867 - $2,618	71%
Select Health	$976 - $1,185	80%
Aetna	$1,185 - $3,483	97%
Cigna	$1,185 - $2,346	97%
Cms	$1,185	97%
Devoted Health	$1,185	97%
Humana	$1,185	97%
Kaiser	$1,185	97%
UnitedHealthcare	$1,185 - $4,608	97%
Simplified Benefits Administration	$2,025 - $2,405	166%
Denver Health Medical Plan	$2,877 - $3,452	235%
Rocky Mountain Health Plan	$2,935	240%
First Health	$3,395	278%
Multiplan	$3,452 - $3,970	282%
Phcs	$4,028	329%

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 $2,014.
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 Longs Peak Hospital 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.