CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Jeff Davis Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,869
Cash Discount Price: $1,339
vs. Medicare Baseline: 2.35x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Jeff Davis Hospital is $2,869. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,339. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 2.35x the Medicare baseline. Located in 163 South Tallahassee Street, Hazlehurst, GA.

Cash / Self-Pay

$1,339

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,869

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: $1,339 (110%)

Insurance Median: $2,869 (235%)

Cash: $1,339 (110% of Medicare)

Ins. Median: $2,869 (235% 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 235% of the Medicare baseline (a markup of 135%). 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
Pen_Network	$294	24%
Medicaid / KanCare	$746 - $2,050	61%
Humana	$761 - $3,251	62%
Peach_State	$761	62%
Wellcare	$761	62%
Medicare (plans)	$1,186 - $1,198	97%
Blue Cross Blue Shield	$1,209 - $2,869	99%
Care_Improvement_Plus	$1,209	99%
Coventry_Hmo	$2,678	219%
Coventry_Pos	$2,678	219%
Uhc_Hmo	$2,869	235%
Uhc_Indemnity	$2,869	235%
Uhc_Ppo	$2,869	235%
Coventry_Ppo	$2,945	241%
Beech_Street	$3,060	250%
Care_Source	$3,060	250%
Cigna	$3,060	250%
One_Health_Ppo	$3,060	250%
Choicecare	$3,251	266%
Community_Care_Network	$3,251	266%
Georgia_Hospital_Network	$3,251	266%
Industry_Buying_Group	$3,251	266%
Novanet	$3,251	266%
Principal_Health_Care_Of_Georgia	$3,251	266%
Three_Rivers_Provider_Network	$3,251	266%
Usa_Managed_Care	$3,251	266%
Memorial_Health_Partners	$3,442	282%
Tricare	$3,557	291%
Multiplan	$3,634	297%

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 $1,339.
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 Jeff Davis 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.