CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Goshen Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,137
  • Cash Discount Price: $18,095
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Goshen Hospital is $1,137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,095. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.93x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.
Cash / Self-Pay
$18,095

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,137

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: $18,095 (1480%)
Insurance Median: $1,137 (93%)
Cash: $18,095 (1480% of Medicare)
Ins. Median: $1,137 (93% 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
Advantage Health Solutions $1,137 93%
Aetna $1,137 93%
Atrio Health Plans $1,137 93%
Bc Federal Employee $1,137 93%
Bc Mcr Advantage Ppo $1,137 93%
Blue Cross Blue Shield $1,137 93%
Buckeye Health Plan $1,137 93%
Cigna $1,137 93%
Coventry Health And Life $1,137 93%
Emblem Health $1,137 93%
Freedom Healthcare $1,137 93%
Geisinger Health Plan $1,137 93%
Health First $1,137 93%
Healthspring $1,137 93%
Humana $1,137 93%
Iehp Empire Health Plan $1,137 93%
Independent Care Health Plan $1,137 93%
Kaiser Permanente $1,137 93%
Mcr Advantra Freedom $1,137 93%
Mcr Allwell Mhs $1,137 93%
Mcr Banner Health $1,137 93%
Mcr Complete $1,137 93%
Mcr Complete Ppo $1,137 93%
Mcr Complete Wellmed $1,137 93%
Mcr Health Alliance $1,137 93%
Mcr Health Partners Plans $1,137 93%
Mcr Medical Mutual Of Ohio $1,137 93%
Mcr Passport Advantage $1,137 93%
Mcr Secure Horizons Ppo $1,137 93%
Mcr Texan Plus $1,137 93%
Mcr Upmc For Life $1,137 93%
Medicare (plans) $1,137 - $1,205 93%
Meridian Complete $1,137 93%
Optimum Healthcare $1,137 93%
Paramount Elite $1,137 93%
Primetime Health Plan $1,137 93%
Simply Complete Hmo $1,137 93%
The Umwa H&R Funds $1,137 93%
Todays Options Pyramid Life $1,137 93%
Trillium Advantage $1,137 93%
Ucare For Seniors $1,137 93%
Ucare Minnesota $1,137 93%
UnitedHealthcare $1,137 93%
Wellcare $1,137 93%
Champva $1,170 96%
Tricare $1,170 96%
Mcr Devoted Health Plan $1,205 99%
Mcr Provider Partners Hlth Pln $1,287 105%
Ambetter / Centene $1,638 134%
Mkt Caresource $1,638 134%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 High Park Ave, Goshen, IN 46526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals