CMS Price Transparency Data

Colonoscopy with biopsy

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,432
Cash Discount Price: $3,479
vs. Medicare Baseline: 1.99x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at University of Iowa Health Care Medical Center Down is $2,432. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,479. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.99x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$3,479

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,432

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: $3,479 (285%)

Insurance Median: $2,432 (199%)

Cash: $3,479 (285% of Medicare)

Ins. Median: $2,432 (199% 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
Aetna	$179 - $3,089	15%
Iowa Total Care	$179 - $1,988	15%
Medical Associates	$179 - $3,330	15%
Molina Healthcare	$179 - $1,988	15%
UnitedHealthcare	$179 - $6,174	15%
Blue Cross Blue Shield	$181 - $2,386	15%
Healthpartners	$183 - $4,224	15%
Wellpoint (Amerigroup)	$188 - $1,165	15%
Immergrun	$661 - $1,242	54%
Quad City Community Healthcare	$710 - $3,728	58%
Aplos Health Plan	$996 - $3,976	81%
Midlands Choice	$1,307 - $3,230	107%
Oscar Health	$1,666 - $3,131	136%
Great River Health Systems	$1,851 - $3,479	151%
Sedgwick	$2,115 - $3,976	173%
Global Excel	$2,247 - $4,224	184%
Sanford Health Plan	$2,247 - $4,224	184%
Employee Benefit Systems	$2,327 - $4,473	190%
Sisco	$2,327 - $4,374	190%
Healthsmart	$2,380 - $4,473	195%
Hfn	$2,432 - $4,572	199%
Multiplan	$2,432 - $4,572	199%

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 $3,479.
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 University of Iowa Health Care Medical Center Down 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.