CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Santa Rosa Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,291
  • Cash Discount Price: $3,416
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Santa Rosa Medical Center is $1,291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,416. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.06x the Medicare baseline. Located in 6002 Berryhill Rd, Milton, FL.
Cash / Self-Pay
$3,416

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,291

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: $3,416 (279%)
Insurance Median: $1,291 (106%)
Cash: $3,416 (279% of Medicare)
Ins. Median: $1,291 (106% 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
Veterans Eval Services $405 33%
Medicaid / KanCare $637 - $739 52%
Humana $656 - $1,230 54%
Wellcare $669 55%
Molina $720 59%
Fl Community Care $732 60%
Tricare $1,187 97%
Aetna $1,230 - $13,658 101%
Blue Cross Blue Shield $1,230 - $5,568 101%
Cigna $1,230 - $5,147 101%
Medicare (plans) $1,230 101%
UnitedHealthcare $1,230 - $4,419 101%
Node Champva $1,250 102%
Node Va $1,250 102%
Node Wellcare Mcr Adv $1,291 106%
Geo Group $1,562 128%
Node Us Dept Of Labor $1,562 128%
Prime Health Work Comp Fl $2,313 189%
Florida Workers Compensation $2,385 195%
Florida State Auto Insurance $2,499 204%
Ambetter / Centene $2,987 244%
Oscar $3,766 308%
Self Pay $5,239 429%
Hospice Of Nw Fl $11,388 931%
Prime Health Services $18,221 1490%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6002 Berryhill Rd, Milton, FL 32570
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals