CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Gibson General Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $304
  • Cash Discount Price: $531
  • vs. Medicare Baseline: 0.25x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Gibson General Hospital is $304. 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 0.25x the Medicare baseline. Located in 1808 Sherman Drive, Princeton, IN.
Cash / Self-Pay
$531

Average discount available for prompt cash payment at this facility.

Insurance Median
$304

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: $304 (25%)
Cash: $531 (43% of Medicare)
Ins. Median: $304 (25% 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
Aetna $180 - $818 15%
Blue Cross Blue Shield $180 - $395 15%
Caresource Just For Me $180 15%
Medicare (plans) $180 15%
Meridiancomplete (Il) $180 15%
Mytruadvantage $180 15%
UnitedHealthcare $180 - $2,060 15%
Va Ccn $180 15%
Medicaid / KanCare $194 16%
Meridiancare (Il) $194 16%
Meridianhealth (Il) $194 16%
Ambetter / Centene $225 18%
Caresource In Marketplace $234 19%
Alliance Coal $252 21%
Claimdoc $252 21%
Hopetrust $270 22%
Hstechnology $270 22%
Noncontracted $288 24%
Deaconess Onecare $297 - $2,550 24%
Chambercare $304 25%
Caresource $395 32%
Mdwise Plans $395 32%
Mhs $395 32%
Ky Racing Health & Welfare Fund $531 43%
Self-Pay $531 43%
Encircle/Encore Combined $622 51%
Encircle/Encore Prime $622 51%
Cigna $818 67%
First Health $818 67%
Healthlink Hmo $818 67%
Healthlink Ppo $818 67%
Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+) $818 67%
Gibson County Sheriff $1,289 105%
Integrated Health $1,365 112%
Principal Health Care $1,365 112%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1808 Sherman Drive, Princeton, IN 47670
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals