CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Lower Keys Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,338
  • Cash Discount Price: $3,902
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Lower Keys Medical Center is $1,338. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,902. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.09x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$3,902

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,338

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: $3,902 (319%)
Insurance Median: $1,338 (109%)
Cash: $3,902 (319% of Medicare)
Ins. Median: $1,338 (109% 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
UnitedHealthcare $62 - $11,114 5%
Veterans Eval Services $405 33%
Florida Childrens Medical Services $972 80%
Medicaid / KanCare $972 - $1,069 80%
South Florida Community Care Network $972 80%
Humana $1,001 - $1,317 82%
Amerigroup $1,069 87%
Positive Healthcare $1,069 87%
Simply Healthcare $1,069 - $3,000 87%
Wellcare $1,069 87%
Wellcare Healthease $1,069 87%
Molina $1,098 90%
Prestige Health Choice $1,127 92%
Magellan $1,166 95%
Tricare $1,271 104%
Blue Cross Blue Shield $1,317 - $14,654 108%
Medicare (plans) $1,317 108%
Ultimate Health $1,317 108%
Node Champva $1,338 109%
Node Non Par Hospice Agree $1,338 109%
Node United Behavioral Va Ccn $1,338 109%
Node Va $1,338 109%
Correct Care Solutions $1,472 120%
Node Us Dept Of Labor $1,673 137%
Prime Health Work Comp Fl $2,265 185%
Fl Work Comp $2,335 191%
Heritage Summit Work Comp Fl $2,335 191%
State Auto Insurance Fl $2,677 219%
Self Pay $3,902 319%
Cigna $8,527 697%
Aetna $10,088 825%
Monroe County $10,839 887%
Evolutions Healthcare Systems $11,562 - $13,730 946%
Keys Energy $11,562 946%
Prime Health Ppo $11,562 946%
Avmed Health Plan $12,285 1005%
Direct Healthcare $14,453 1182%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals