CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Witham Health Services

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,291
Cash Discount Price: $1,027
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Witham Health Services is $1,291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,027. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.06x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$1,027

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,291

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: $1,027 (84%)

Insurance Median: $1,291 (106%)

Cash: $1,027 (84% of Medicare)

Ins. Median: $1,291 (106% 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
Blue Cross Blue Shield	$909 - $1,467	74%
Aetna	$1,085 - $1,304	89%
UnitedHealthcare	$1,144	94%
Mdwise Health In-All Plans	$1,266	104%
Caresource Mcr Adv	$1,291	106%
Phcs/Multiplan-All Plans	$1,335	109%
Sagamore-All Plans	$1,350	110%
Humana	$1,364	112%
Beech Street-All Plans	$1,379	113%
Encore-All Plans	$1,394	114%
Caresource Indiana Marketplace-All Other Plans	$2,406	197%
Mhs Comml Exch-All Plans	$3,667	300%

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 $1,027.
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 Witham Health Services 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.