CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Northwest Health-La Porte

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $870
  • Cash Discount Price: $367
  • vs. Medicare Baseline: 0.71x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Northwest Health-La Porte is $870. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $367. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.71x the Medicare baseline. Located in 1007 Lincolnway, La Porte, IN.
Cash / Self-Pay
$367

Average discount available for prompt cash payment at this facility.

Insurance Median
$870

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: $367 (30%)
Insurance Median: $870 (71%)
Cash: $367 (30% of Medicare)
Ins. Median: $870 (71% 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
Lutheran $147 - $1,199 12%
One Call $167 14%
Self Pay $180 - $6,200 15%
Php $225 - $7,762 18%
Lutheran Preferred Medpartners $227 - $7,854 19%
Alpha Baking $245 - $8,455 20%
Php Freedom Network $327 - $11,307 27%
Encore $354 - $16,910 29%
County Of Laporte $381 - $13,152 31%
UnitedHealthcare $398 - $13,227 33%
Cigna $404 - $13,960 33%
Prime Health Services $408 - $14,091 33%
Prime Health Services Auto $408 - $14,091 33%
Aetna $423 - $15,538 35%
Ihn $435 - $15,031 36%
Community Health Alliance $473 - $16,346 39%
Lutheran Network $479 - $16,534 39%
Sagamore Health Network $479 - $16,534 39%
Chandler Group $490 - $16,910 40%
Hfn Workers Compensation $490 - $16,910 40%
Multiplan $490 - $16,910 40%
Phcs $490 - $16,910 40%
Tricare $1,203 98%
Blue Cross Blue Shield $1,248 - $5,160 102%
Humana $1,248 - $3,122 102%
Medicare (plans) $1,248 102%
Node Champva $1,266 104%
Node Hospice Non Par Agree $1,269 104%
Node Va $1,269 104%
Va Choice Program $1,269 104%
Node Devoted Health Mcr Adv $1,273 104%
Managed Health Services $1,311 - $3,122 107%
Indiana Dept Of Correction $1,320 108%
Node Pphp Mcr Adv $1,332 109%
Us Department Of Labor $1,586 130%
Prime Health In Work Comp $2,284 187%
Caresource $2,401 - $3,122 196%
In Wc $2,538 208%
Encore Kba Epo $3,045 249%
Magnacare Ma $3,106 254%
Medicaid / KanCare $3,122 255%
Mhs $3,122 255%
Encore Kba Ppo $3,806 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Lincolnway, La Porte, IN 46350
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals