CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Lutheran Hospital of Indiana

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $566
  • Cash Discount Price: $356
  • vs. Medicare Baseline: 0.46x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Lutheran Hospital of Indiana is $566. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $356. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.46x the Medicare baseline. Located in 7950 W Jefferson Blvd, Fort Wayne, IN.
Cash / Self-Pay
$356

Average discount available for prompt cash payment at this facility.

Insurance Median
$566

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: $356 (29%)
Insurance Median: $566 (46%)
Cash: $356 (29% of Medicare)
Ins. Median: $566 (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.

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
Ky Work Comp $158 - $2,841 13%
One Call Care Diagnostics $167 14%
Amish Aid $189 - $3,382 15%
Lutheran Preferred Network $189 - $6,764 15%
Self Pay $189 - $3,382 15%
Cigna $203 - $4,092 17%
Physicians Health Plan Of Northern Indiana $248 - $4,451 20%
Aetna $252 - $5,366 21%
Lutheran Preferred $252 - $1,144 21%
Sagamore $287 - $6,099 23%
Encore Ppo $308 - $5,513 25%
Lutheran Network $314 - $5,637 26%
Veterans Eval Services $385 31%
Multiplan $459 - $9,357 38%
Prime Health Services $472 - $8,455 39%
Encore Health Network $516 - $10,146 42%
Advantage Health Solutions $522 - $9,357 43%
Allied Benefit Systems $566 - $10,146 46%
Evolutions $566 - $10,146 46%
Blue Cross Blue Shield $629 - $5,203 51%
UnitedHealthcare $1,121 - $6,759 92%
Tricare $1,203 98%
Humana $1,246 - $3,122 102%
Iu Health Plan $1,246 102%
Managed Health Services $1,246 - $3,122 102%
Medicare (plans) $1,246 102%
Department Of Veterans Affairs $1,266 104%
Node Hospice Non Par Agree $1,266 104%
Node Va $1,266 104%
Node Devoted Health Mcr Adv $1,271 104%
In Dept Of Correction $1,317 108%
Node Pphp Mcr Adv $1,329 109%
Us Department Of Labor $1,583 129%
Lutheran Advanced Network $1,899 155%
Node Lutheran Network $1,899 - $2,216 155%
Node Lutheran Preferred Fixed 2 $1,899 155%
Align Network $2,026 166%
Encore Work Comp In $2,279 186%
Php Freedom Network $2,851 233%
Node Encore Kba Epo $3,039 249%
Care Source $3,122 255%
Medicaid / KanCare $3,122 255%
Node Encore Kba Ppo $3,798 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7950 W Jefferson Blvd, Fort Wayne, IN 46804
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals