CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Cleveland Clinic Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,033
Cash Discount Price: $2,471
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Cleveland Clinic Hospital is $1,033. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,471. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.84x the Medicare baseline. Located in 3100 Weston Rd, Weston, FL.

Cash / Self-Pay

$2,471

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,033

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: $2,471 (202%)

Insurance Median: $1,033 (84%)

Cash: $2,471 (202% of Medicare)

Ins. Median: $1,033 (84% 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
Avmed	$204 - $2,556	17%
Blue Cross Blue Shield	$204 - $4,258	17%
Doctors Health Plan	$204 - $1,184	17%
United	$204 - $2,932	17%
Wellcare	$204 - $1,184	17%
Independent Living Systems	$215 - $1,243	18%
Clear Spring Health	$221 - $271	18%
Aetna	$253 - $4,014	21%
UnitedHealthcare	$311	25%
Cigna	$326 - $1,694	27%
Medicaid / KanCare	$327	27%
Maritime	$766 - $3,036	63%
Multiplan	$766 - $5,162	63%
Clarity Health	$995 - $3,947	81%
The Legacy Companies	$995 - $3,947	81%
Consociate Health	$1,148	94%
Humana	$1,184	97%
Devoted Health	$1,302	106%
Bmi	$3,340	273%

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 $2,471.
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 Cleveland Clinic Hospital 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.