Colonoscopy with biopsy
Facility: PAM Health Rehabilitation Hospital of Greater Indiana
Billing Code: 45380 (CPT)
This hospital's typical commercial price is $1,154 compared to the $625 fair price benchmark.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Highest price of the 9 IN hospitals we have prices for — worth calling around.
Black dot = this hospital, among the 9 IN hospitals with a price for this procedure. Full list below.
Note: The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.
A fair price for a Colonoscopy with biopsy is about $625 (about 0.5× the $1,223 Medicare rate). PAM Health Rehabilitation Hospital of Greater Indiana charges insurers about $1,154, or about $4,872 in cash — well above the fair price. Located in Clarksville, IN.
This price is above the fair BaseRate — you may be able to pay less
Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $625. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $1,154 | 94% |
| Blue Cross Blue Shieldmajor | $1,154 - $1,443 | 94% |
| Aetnamajor | $1,218 | 100% |
| Humanamajor | $1,154 | 94% |
| Ambetter (Centene) | $1,154 | 94% |
| CareSource | $1,385 | 113% |
| WellCare | $1,154 | 94% |
| + 9 smaller / regional plans | $1,120 - $3,654 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at PAM Health Rehabilitation Hospital of Greater Indiana
Compare: Colonoscopy with biopsy at other IN hospitals
- Johnson Memorial Hospital · Franklin $167
- Decatur County Memorial Hospital · Greensburg $167
- Harrison County Hospital · Corydon $178
- Woodlawn Hospital · Rochester $180
- Daviess Community Hospital · Washington $184
- Pulaski Memorial Hospital · Winamac $184
- Rush Memorial Hospital · Rushville $195
- Henry County Memorial Hospital · New Castle $210
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at PAM Health Rehabilitation Hospital of Greater Indiana (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $1,769
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $1,769).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
PAM Health Rehabilitation Hospital of Greater Indiana's published 45 CFR § 180 self-pay cash rate is $4,872 (vs. $1,154 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $625 Fair BaseRate ($1,223 Medicare)
Your bill ($4,872) is $4,247 above the denoised Fair BaseRate ($625) and 4.0× the $1,223 Medicare rate.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.