CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Amita Health Resurrection Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,276
Cash Discount Price: $1,276
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Amita Health Resurrection Medical Center is $1,276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,276. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.04x the Medicare baseline. Located in 7435 W Talcott Avenue, Chicago, IL.

Cash / Self-Pay

$1,276

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,276

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: $1,276 (104%)

Insurance Median: $1,276 (104%)

Cash: $1,276 (104% of Medicare)

Ins. Median: $1,276 (104% 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
Ravenswood Physicians Associates Ipa	$197 - $1,276	16%
Resurrection Physicians Provider Group Ipa	$197 - $1,276	16%
Cigna	$488 - $4,550	40%
Standard Eapg Logic	$854	70%
Aetna	$855 - $1,978	70%
Blue Cross Blue Shield	$855 - $1,786	70%
Countycare	$855	70%
Humana	$855 - $1,404	70%
Medicaid / KanCare	$855	70%
Meridian	$897 - $1,340	73%
Molina	$897 - $1,914	73%
Celtic (Wellcare)	$1,276	104%
Clear Spring Health Of Illinois	$1,276	104%
Devoted Health	$1,276	104%
Essential Health Partners	$1,276 - $1,467	104%
Illinois Physicians Alliance	$1,276	104%
Longevity Health Plan Of Illinois	$1,276	104%
Medicare (plans)	$1,276	104%
Self-Pay	$1,276	104%
Tricare	$1,276	104%
UnitedHealthcare	$1,276 - $2,821	104%
Zing Health Provider Network	$1,314	107%
Providers Partners Health Plan	$1,340	110%
Access Community Health Network	$1,531	125%
Clifton Health System	$1,978	162%
Ambetter / Centene	$2,067	169%
Hfn Inc (Healthcare Finest Network)	$2,517	206%
Coventry	$2,571	210%
Workers Comp	$2,571	210%

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 $1,276.
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 Amita Health Resurrection Medical 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.