CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Dupont Hospital LLC

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $581
  • Cash Discount Price: $297
  • vs. Medicare Baseline: 0.48x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Dupont Hospital LLC is $581. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $297. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.48x the Medicare baseline. Located in 2520 E Dupont Rd, Fort Wayne, IN.
Cash / Self-Pay
$297

Average discount available for prompt cash payment at this facility.

Insurance Median
$581

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: $297 (24%)
Insurance Median: $581 (48%)
Cash: $297 (24% of Medicare)
Ins. Median: $581 (48% 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 $170 - $3,101 14%
Self Pay $170 - $3,101 14%
Lutheran Preferred $187 - $6,892 15%
Cigna $203 - $4,169 17%
Aetna $233 - $5,134 19%
Physicians Health Plan $244 - $4,447 20%
Encore Ppo $314 - $5,743 26%
Lutheran Network $314 - $5,743 26%
Medical Mutual Of Oh $333 - $6,088 27%
Sagamore $338 - $6,398 28%
Veterans Eval Services $385 31%
Prime Health Services $472 - $8,615 39%
Frontpath $503 - $9,189 41%
Encore Health Network $516 - $10,338 42%
Advantage Health Solutions $522 - $9,534 43%
Multiplan $541 - $10,338 44%
Allied Benefit Systems $566 - $10,338 46%
UnitedHealthcare $1,121 - $6,759 92%
Tricare $1,203 98%
Blue Cross Blue Shield $1,246 - $5,203 102%
Humana $1,246 - $3,122 102%
Medicare (plans) $1,246 102%
Node Mhs Mcr Adv $1,246 102%
Department Of Veterans Affairs $1,266 104%
Iu Health $1,266 104%
Node Non Par Hospice 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%
Lutheran Preferred Fixed 2 $1,899 155%
Managed Health Services $1,899 - $3,122 155%
Align In Work Comp $2,026 166%
Encore Work Comp In $2,279 186%
In Work Comp $2,532 207%
Php Freedom Network $2,851 233%
Encore Kba Epo $3,039 249%
Caresource $3,122 255%
Medicaid / KanCare $3,122 255%
Encore Kba Ppo $3,798 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2520 E Dupont Rd, Fort Wayne, IN 46825
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals