CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Baptist Health Medical Center - Jacksonville

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $972
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Baptist Health Medical Center - Jacksonville is $972. 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 0.80x the Medicare baseline. Located in 800 Prudential Dr, Jacksonville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$972

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: $972 (80%)

Ins. Median: $972 (80% 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
Amerigroup Of Georgia	$637	52%
Caresource Of Georgia	$637	52%
Daniel Memorial	$637	52%
Humana	$637 - $701	52%
Peach State Health Plan	$637	52%
Simply Healthcare Plans	$669 - $764	55%
Simply Healthcare Plans - Cha	$669	55%
Amerihealth Caritas	$701	57%
Florida Community Care	$701 - $1,243	57%
Sunshine State Health Plan	$701	57%
United Community Plan	$701	57%
Vivida Health	$701	57%
Molina Healthcare Of Florida	$758	62%
Aetna	$764 - $1,207	62%
Community Hospice Of Northeast Florida	$1,179 - $1,184	96%
Pace	$1,179 - $1,184	96%
Tomorrow'S Rainbow	$1,179 - $1,184	96%
Va Ccn	$1,179 - $1,184	96%
UnitedHealthcare	$1,191 - $1,195	97%
Devoted	$1,250 - $1,255	102%
Upmc	$1,297 - $1,302	106%
Ambetter / Centene	$2,830 - $2,840	231%
Corvel	$3,291	269%

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 $X.
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 Baptist Health Medical Center - Jacksonville 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.