CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Shands Jacksonville

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $2,188
  • Cash Discount Price: $3,439
  • vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Shands Jacksonville is $2,188. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,439. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.79x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.
Cash / Self-Pay
$3,439

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,188

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: $3,439 (281%)
Insurance Median: $2,188 (179%)
Cash: $3,439 (281% of Medicare)
Ins. Median: $2,188 (179% 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
Carelon Health $701 57%
Humana $701 - $5,315 57%
Aetna $705 - $5,153 58%
Florida Community Care $732 60%
Amerihealth Caritas Florida $764 62%
Community Care Plan $764 62%
Molina $764 - $1,539 62%
Simply Healthcare $769 63%
Ameri-Plus Preferred Care $1,250 102%
Blue Cross Blue Shield $1,250 - $3,364 102%
Capital Health Plan $1,250 - $3,127 102%
Beacon Health Strategies $1,287 105%
Careplus Health Plan $1,287 105%
Florida Health Care Plan $1,287 - $2,130 105%
UnitedHealthcare $1,300 - $4,595 106%
Positive Healthcare Partners $1,302 - $1,375 106%
Devoted Health Plan $1,312 - $1,375 107%
Wellcare Of Florida $1,462 120%
Florida Complete Care $1,562 128%
Avmed $1,761 - $1,797 144%
Cigna $1,777 145%
Wellpath $1,953 160%
Ambetter / Centene $1,965 161%
Truli For Health $2,246 184%
Volusia Health Network $2,626 215%
Northeast Florida State Hospital $2,751 225%
North Florida Evaluation & Treatment Center $2,939 240%
Centivo $3,439 281%
Disney Cruise Line $3,752 307%
Health First Health Plan $4,064 - $4,377 332%
Mental Health Associates $4,064 332%
Prime Health Services $4,377 358%
Florida Health Alliance $4,502 368%
Archbold Medical Center $4,690 384%
Genex $4,690 384%
First Health $5,315 435%
Florida Hospital Healthcare System $5,315 435%
Medsave Usa Tpa $5,315 435%
Fringe Benefits Coordinators $5,628 - $5,940 460%
Multiplan $5,628 460%
Novanet $5,628 460%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 655 W 8Th St, Jacksonville, FL 32209
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals