CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Fhn Memorial Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,538
Cash Discount Price: $2,452
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Fhn Memorial Hospital is $1,538. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,452. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.26x the Medicare baseline. Located in 1045 West Stephenson Street, Freeport, IL.

Cash / Self-Pay

$2,452

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,538

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: $2,452 (201%)

Insurance Median: $1,538 (126%)

Cash: $2,452 (201% of Medicare)

Ins. Median: $1,538 (126% 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	$181 - $2,406	15%
Health Alliance Mcr Adv	$181 - $1,282	15%
Humana	$181 - $3,417	15%
Quartz Mcr Adv	$181 - $1,282	15%
UnitedHealthcare	$181 - $3,370	15%
Osf Healthplans - All Plans	$254 - $4,320	21%
Blue Cross Blue Shield	$412 - $2,916	34%
The Alliance - All Plans	$536 - $2,590	44%
Meridian Health Plan - All Plans	$854	70%
Ecoh Nihp	$948 - $2,722	78%
Ecoh - All Other Plans	$1,043 - $2,938	85%
Nihp Employ - All Plans	$1,043 - $2,722	85%
Quartz - All Other Plans	$1,085 - $2,808	89%
Northern Il Hp - All Plans	$1,248 - $2,981	102%
First Health - All Plans	$1,272 - $3,037	104%
Hfn - All Plans	$1,483 - $3,543	121%
First Choice Il - All Plans	$1,538 - $3,672	126%
Multiplan Phcs - All Plans	$1,538 - $3,672	126%
Wps - All Plans	$1,581 - $3,776	129%
Galaxy - All Plans	$1,628 - $3,888	133%
Health Alliance - All Other Plans	$1,628 - $3,888	133%
Interplan Health - All Plans	$1,628 - $3,888	133%
Midland Choice - All Plans	$1,628 - $4,104	133%
Preferred Plan Ppo - All Plans	$1,628 - $3,888	133%
Trustmark - All Plans	$1,664 - $3,975	136%

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 $2,452.
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 Fhn Memorial 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.