CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Manning Regional Healthcare Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $958
Cash Discount Price: $1,672
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Manning Regional Healthcare Center is $958. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,672. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.78x the Medicare baseline. Located in 1550 Sixth Street, Manning, IA.

Cash / Self-Pay

$1,672

Average discount available for prompt cash payment at this facility.

Insurance Median

$958

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: $1,672 (137%)

Insurance Median: $958 (78%)

Cash: $1,672 (137% of Medicare)

Ins. Median: $958 (78% 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
Medical Associates Mcr	$165 - $2,643	13%
Medicare (plans)	$165 - $2,643	13%
Merigold Mcr Adv-All Plans	$165 - $2,643	13%
Tricare	$165 - $2,643	13%
UnitedHealthcare	$165 - $3,663	13%
Oscar Epo-All Plans	$286 - $3,965	23%
Medical Associates Comm-All Other Plans	$314 - $2,832	26%
Preferred Health - All Plans	$314 - $2,832	26%
Wellmark Hmo	$391	32%
Wellmark Ppo-All Other Plans	$391	32%
Midlands Choice- All Plans	$408 - $3,700	33%
Aetna	$616 - $3,700	50%
Iowa Total Care Mcaid-All Plans	$953 - $2,812	78%
Medicaid / KanCare	$963 - $2,839	79%

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 $1,672.
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 Manning Regional Healthcare Center 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.