CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Fairview Park Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $3,089
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.53x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Fairview Park Hospital is $3,089. 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 2.53x the Medicare baseline. Located in 200 Industrial Boulevard, Dublin, GA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,089

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: $3,089 (253%)

Ins. Median: $3,089 (253% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 253% of the Medicare baseline (a markup of 153%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Peach State	$1,150	94%
Wellcare	$1,150	94%
Health One Alliance	$1,230	101%
Memorial Health Plan	$1,488 - $1,898	122%
Americas 1St Choice	$2,205	180%
Amerigroup	$2,365	193%
Nhc Advantage	$2,550	209%
Pruitt Health	$2,550	209%
Aetna	$2,595 - $3,633	212%
Prime Health	$2,965	243%
Employer'S Health Network	$3,027	248%
Rockport United Network	$3,027	248%
Identity Mco	$3,089	253%
Synergy Health Network	$3,089	253%
Cigna	$3,224 - $4,299	264%
Friday Health	$3,224	264%
United	$3,348	274%
Blue Cross Blue Shield	$6,098 - $7,417	499%
Core Resources	$7,155	585%
Centurion	$7,512	614%

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 Fairview Park 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.