CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Ochsner Medical Center Acute

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,098
Cash Discount Price: $675
vs. Medicare Baseline: 1.72x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Ochsner Medical Center Acute is $2,098. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $675. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.72x the Medicare baseline. Located in 1516 Jefferson Hwy, New Orleans, LA.

Cash / Self-Pay

$675

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,098

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: $675 (55%)

Insurance Median: $2,098 (172%)

Cash: $675 (55% of Medicare)

Ins. Median: $2,098 (172% 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
Tricare	$424 - $1,083	35%
Humana	$481 - $1,083	39%
UnitedHealthcare	$481 - $4,123	39%
Healthy Blue (Healthy Louisiana)	$491	40%
Louisiana Healthcare Connections (Healthy Louisiana)	$491	40%
Aetna	$496 - $1,748	41%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$496	41%
Medicaid / KanCare	$874 - $918	71%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$1,083	89%
Blue Cross Blue Shield	$1,083 - $3,017	89%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$1,083	89%
Medicare (plans)	$1,083	89%
Ochsner Health Plan	$1,083	89%
Pace New Orleans	$1,191	97%
Christus Health Exchange Plan	$1,896	155%
First Health Network	$2,300	188%
Louisiana Workers' Compensation Corporation (Lwcc)	$2,300	188%
Mississippi Physicians Care Network	$2,300	188%
Healthcomp & Personify Health (Formerly Gilsbar)	$2,423	198%
Claritev D/B/A Multiplan/Phcs/American Life Care	$2,454	201%
Zelis	$2,454	201%
Employers Health Network (Ehn)	$2,607	213%
Prime Health Services Ppo	$2,607	213%
Usa Managed Care Network	$2,607	213%
Behavioral Health Systems	$2,760	226%
Evolutions Healthcare	$2,760	226%
Galaxy Health Network Ppo	$2,760	226%
Galaxy Health Network Wc	$2,760	226%
Cigna	$4,350	356%

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 $675.
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 Ochsner Medical Center Acute 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.