CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Rockcastle County Hospital, Inc.

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $551
  • Cash Discount Price: $621
  • vs. Medicare Baseline: 0.45x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Rockcastle County Hospital, Inc. is $551. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $621. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.45x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$621

Average discount available for prompt cash payment at this facility.

Insurance Median
$551

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: $621 (51%)
Insurance Median: $551 (45%)
Cash: $621 (51% of Medicare)
Ins. Median: $551 (45% 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
Passport Hp Hmo - All Plans $155 - $286 13%
Caresource Mcaid $192 16%
Coventry Mcaid-All Plans $192 16%
Medicaid / KanCare $192 16%
Molina Mcaid $192 16%
UnitedHealthcare $192 - $350 16%
Humana $322 - $1,123 26%
Blue Cross Blue Shield $390 - $1,123 32%
Multiplan-All Plans $488 - $902 40%
Prime Health Services-All Plans $488 - $902 40%
Integrated Hp-All Plans $511 - $944 42%
Corvel - All Plans $517 - $955 42%
Center Care-All Plans $545 - $1,008 45%
Cigna $557 - $1,029 46%
Tricare $842 69%
Caresource Mcr Adv-All Other Plans $1,123 92%
Molina Marketplace - All Other Plans $1,123 92%
Molina Mcr Adv $1,123 92%
Signature Mcr Adv-All Plans $1,123 92%
Wellcare Mcr Adv-All Other Plans $1,123 92%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals