CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Davis County Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $248
  • Cash Discount Price: $1,230
  • vs. Medicare Baseline: 0.20x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Davis County Hospital is $248. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,230. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.20x the Medicare baseline. Located in 509 North Madison Street, Bloomfield, IA.
Cash / Self-Pay
$1,230

Average discount available for prompt cash payment at this facility.

Insurance Median
$248

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: $1,230 (101%)
Insurance Median: $248 (20%)
Cash: $1,230 (101% of Medicare)
Ins. Median: $248 (20% 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.

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 $165 13%
Choicecare Mcr Adv $165 13%
Home State Hlth Exch - All Other Plans $165 13%
Home State Hlth Mcr $165 13%
Tricare $165 13%
Amerigroup Mcr Adv-All Other Plans $168 14%
American Hp Mcr Adv-All Plans $173 14%
Mt Carmel Hp-All Plans $173 14%
Choicecare Comm - All Other Plans $248 20%
Preferred Hlth Choices - All Plans $314 26%
Blue Cross Blue Shield $379 - $446 31%
Midlands Choice - All Plans $511 42%
Home State Hlth Mcaid $1,230 101%
Iowa Total Care Mcaid-All Plans $1,255 103%
Molina Mcaid-All Plans $1,261 103%
Amerigroup Mcaid $1,267 104%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 North Madison Street, Bloomfield, IA 52537
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals