CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Halifax Health Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,184
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Halifax Health Medical Center is $1,184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.97x the Medicare baseline. Located in 303 N Clyde Morris Blvd, Daytona Beach, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,184

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%)
Insurance Median: $1,184 (97%)
Ins. Median: $1,184 (97% 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
Embs $1,006 82%
Tricare $1,086 89%
Humana $1,148 - $2,355 94%
Aetna $1,184 - $2,444 97%
Americas Choice Provider Network $1,184 97%
Blue Cross Blue Shield $1,184 97%
Cigna $1,184 97%
Coventry $1,184 97%
Division Of The Blind $1,184 97%
Freedom Health $1,184 97%
Medicare (plans) $1,184 97%
Optimum Healthcare $1,184 97%
Sunshine State Health Plan $1,184 - $2,367 97%
UnitedHealthcare $1,184 97%
Wellcare $1,184 97%
Molina $1,207 99%
Devoted Health $1,231 101%
Independent Living Systems $1,243 102%
Longevity $1,243 102%
Prime Health Services $1,243 102%
Clear Spring Health Of Fl $1,290 106%
Evolutions $1,775 145%
Employers Health Network $2,367 194%
Fhcp $2,391 196%
Centivo $2,545 208%
Florida Healthcare $2,568 210%
Claimdoc $2,663 218%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals