CMS Price Transparency Data

Colonoscopy with biopsy

Facility: The Women's Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $395
  • Cash Discount Price: $531
  • vs. Medicare Baseline: 0.32x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at The Women's Hospital is $395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $531. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.32x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.
Cash / Self-Pay
$531

Average discount available for prompt cash payment at this facility.

Insurance Median
$395

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: $531 (43%)
Insurance Median: $395 (32%)
Cash: $531 (43% of Medicare)
Ins. Median: $395 (32% 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
Blue Cross Blue Shield $180 - $3,853 15%
Caresource $180 - $1,052 15%
Humana $180 - $1,052 15%
Iu Health $180 - $1,052 15%
Meridian Health Il $180 - $1,052 15%
Mhs $180 - $1,052 15%
Molina Il $180 - $1,052 15%
Molina Ky $180 - $1,052 15%
Molina Ky Dual $180 - $1,052 15%
UnitedHealthcare $180 - $5,242 15%
Wellcare Ky $180 - $1,052 15%
Aetna $192 - $818 16%
Passport Molina Ky $192 16%
Ambetter / Centene $207 - $1,630 17%
Immergrun $218 - $1,262 18%
Caresource Marketplace (Just4Me) $234 - $1,578 19%
Hst $243 - $1,578 20%
Alliance Coal $249 20%
Allied National/Zelis - Freedom Plan $252 - $2,577 21%
Claimdoc $261 - $1,525 21%
Patoka Valley Health Care (80/20 Plan) $270 22%
Patoka Valley Health Care (90/10 Plan) $270 22%
Hope Trust $288 - $1,736 24%
Noncontracted $288 - $1,683 24%
One Care $297 24%
Chamber Care $300 25%
Caresource Hip $395 32%
Caresource In $395 32%
Mdwise Hip $395 32%
Mhs Behavioral $395 32%
Amish $421 - $531 34%
Self Pay $531 43%
Encorecombined $622 51%
Encoreprime $622 51%
Cigna $818 67%
Claritev (Formerly Phcs/Mulitplan) $818 67%
First Health/Coventry $818 67%
Healthlink $818 67%
Sagamore $818 67%
Center Care $910 74%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4199 Gateway Blvd, Newburgh, IN 47630
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals