CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Deaconess Illinois Crossroads

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $561
Cash Discount Price: $531
vs. Medicare Baseline: 0.46x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Deaconess Illinois Crossroads is $561. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $531. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.46x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.

Cash / Self-Pay

$531

Average discount available for prompt cash payment at this facility.

Insurance Median

$561

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: $531 (43%)

Insurance Median: $561 (46%)

Cash: $531 (43% of Medicare)

Ins. Median: $561 (46% 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	$190 - $1,254	16%
Blue Cross Blue Shield	$190 - $1,229	16%
Humana	$190 - $1,229	16%
Meridian Health Plan	$190 - $1,229	16%
Molina Healthcare Of Illinois	$190 - $1,241	16%
Mytru Advantage	$190 - $1,229	16%
Umwa	$190 - $1,229	16%
UnitedHealthcare	$190 - $1,229	16%
Wellcare	$190 - $1,229	16%
Healthlink	$235 - $245	19%
Alliance Coal	$262 - $2,028	21%
Alter-Net Medical Services, Inc.	$304 - $3,503	25%
Noncontracted	$304 - $1,967	25%
Deaconess Onecare	$389	32%
Self-Pay	$531	43%
Cigna	$590	48%
Prime Health Services	$1,138	93%
Care Improvement Plus	$1,254	103%
Guardian Resources, Inc.	$1,274	104%
Healthcare'S Finest Network (Hfn)	$1,289	105%
Medicalcontrol Network Solutions	$1,289	105%
National Provider Network	$1,289	105%
Three Rivers Provider Network	$1,320	108%
Beech Street	$1,335	109%
Hope Trust	$3,503	287%

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 $531.
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 Deaconess Illinois Crossroads 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.