CMS Price Transparency Data

Colonoscopy with biopsy

Facility: H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc.

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $330
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc. is $330. 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 0.27x the Medicare baseline. Located in 12902 Magnolia Dr, Tampa, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$330

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: $330 (27%)

Ins. Median: $330 (27% 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
Simply	$150	12%
United Hc	$157 - $7,883	13%
Blue Cross Blue Shield	$197 - $651	16%
Aetna	$200 - $462	16%
Devoted	$200 - $421	16%
Humana	$200 - $421	16%
Careplus	$210 - $442	17%
Baycare	$214 - $451	18%
Freedom Health	$220 - $463	18%
Optimum	$220 - $463	18%
Evolutions	$236 - $497	19%
Avmed	$280 - $590	23%
Health First	$300 - $632	25%
Multiplan	$320 - $674	26%
Cigna	$357	29%

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 H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc. 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.