CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Bluffton Regional Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $692
  • Cash Discount Price: $346
  • vs. Medicare Baseline: 0.57x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Bluffton Regional Medical Center is $692. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $346. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.57x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
$346

Average discount available for prompt cash payment at this facility.

Insurance Median
$692

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: $346 (28%)
Insurance Median: $692 (57%)
Cash: $346 (28% of Medicare)
Ins. Median: $692 (57% 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
Amish Aid $151 - $3,888 12%
Self Pay $151 - $3,888 12%
Lutheran Preferred Network $188 - $12,959 15%
Cigna $199 - $5,735 16%
Aetna $228 - $7,225 19%
Php Management Systems $244 - $6,272 20%
Lutheran Trma $252 - $1,121 21%
UnitedHealthcare $294 - $8,002 24%
Encore Ppo $308 - $7,921 25%
Sagamore Sebt $321 - $8,278 26%
Sagamore Health Newtork Inc $337 - $8,683 28%
Veterans Eval Services $385 31%
Consumer Life $390 - $10,044 32%
Ahg Dana Employees $409 - $3,165 33%
Align Networks $440 - $11,339 36%
Prime Health Services $472 - $12,149 39%
Private Healthcare Systems Inc $472 - $12,149 39%
Multiplan $503 - $12,959 41%
Encore Health Network $516 - $14,579 42%
Advantage 360 $522 - $13,445 43%
Community Health Alliance $535 - $13,769 44%
First Health $541 - $13,931 44%
Allied Benefit Systems $566 - $14,579 46%
Cardinal Health Alliance $566 - $14,579 46%
Ppom $566 - $14,579 46%
Tricare $1,203 98%
Blue Cross Blue Shield $1,246 - $5,203 102%
Medicare (plans) $1,246 102%
Node Iu Health Mcr Adv $1,246 102%
Node Mhs Mcr Adv $1,246 102%
Department Of Veterans Affairs $1,266 104%
Humana $1,266 - $3,122 104%
Node Non Par Hospice Agree $1,266 104%
Node Va $1,266 104%
Northeast Hospice $1,266 104%
Node Caresource Mcr Adv $1,271 104%
Node Devoted Health Mcr Adv $1,271 104%
County Jail Health Care $1,317 108%
In Dept Of Correction $1,317 108%
Node Pphp Mcr Adv $1,329 109%
Us Department Of Labor $1,583 129%
Physicians Health Plan $1,689 138%
Php $1,792 147%
Lutheran Advanced Network $1,899 155%
Lutheran Three Rivers Preferred Plus 150 $1,899 155%
Lutheran Three Rivers Preferred Plus 175 $2,216 181%
Encore Work Comp In $2,279 186%
Lutheran Northwest Health Preferred $2,532 207%
Managed Health Services Exchange $2,532 207%
Workers Compensation $2,532 207%
Php Freedom Network $2,690 220%
Encore Kba Epo $3,039 249%
Caresource $3,122 255%
Medicaid / KanCare $3,122 255%
Mhs $3,122 255%
Mhs In Hip $3,122 255%
Encore Kba Ppo $3,798 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals