CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Terrebonne General Medical Center - Parish

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,138
Cash Discount Price: $1,816
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Terrebonne General Medical Center - Parish is $1,138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,816. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.93x the Medicare baseline. Located in 8166 Main Street, Houma, LA.

Cash / Self-Pay

$1,816

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,138

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: $1,816 (149%)

Insurance Median: $1,138 (93%)

Cash: $1,816 (149% of Medicare)

Ins. Median: $1,138 (93% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicaid / KanCare	$439	36%
UnitedHealthcare	$439 - $1,084	36%
Amerihealth	$448	37%
Aetna	$452 - $2,011	37%
Humana	$461 - $3,259	38%
Champ Va	$590	48%
Blue Cross Blue Shield	$1,066 - $2,500	87%
Dept Of Veterans Affairs	$1,066	87%
Medicare (plans)	$1,066	87%
Tricare	$1,084	89%
Amg	$1,138	93%
Ppoplus	$1,186	97%
Verity Health	$1,398	114%
Multiplan Inc	$1,594	130%
Cigna	$1,646	135%
Coventry Health Of Louisiana	$1,962	160%
Workers Comp	$2,453	201%
Vantage Health Plan	$2,709	222%
Gilsbar 360	$2,912 - $2,955	238%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,816.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 45380.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Terrebonne General Medical Center - Parish is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 45380.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.