CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Claiborne Memorial Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,400
  • Cash Discount Price: $1,400
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Claiborne Memorial Medical Center is $1,400. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,400. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.15x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$1,400

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,400

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: $1,400 (115%)
Insurance Median: $1,400 (115%)
Cash: $1,400 (115% of Medicare)
Ins. Median: $1,400 (115% 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
Ambetter / Centene $250 20%
Medicaid / KanCare $250 - $602 20%
Aetna $468 - $910 38%
Amerihealth Caritas La $468 - $602 38%
Community Health Solution $468 - $602 38%
Correctcare Intergrated $468 - $602 38%
Healthy Blue $468 - $602 38%
Humana $468 - $1,400 38%
Louisiana Hc Connections $468 - $602 38%
Magellan Services $468 - $602 38%
UnitedHealthcare $468 - $1,277 38%
Commercial Insurance $560 - $1,400 46%
Meritain Health $560 - $910 46%
Sedgwick Claims Mgmt Serv $651 - $1,260 53%
Workman'S Comp $651 - $1,260 53%
Coventry Healthcare $840 69%
Geha $980 80%
Health Plus Of La $980 - $1,050 80%
Apwu Healthplan $1,050 86%
Cigna $1,050 86%
Great West Healthcare $1,050 86%
Phcs $1,120 92%
Ppo Plus $1,120 92%
All Savers $1,277 104%
Golden Rule Ins Co $1,277 104%
United Behavioral Health $1,277 104%
Aarp $1,400 115%
Accordia National $1,400 115%
Aflac $1,400 115%
Alameda Alliance Forhealt $1,400 115%
American Pioneer $1,400 115%
Benefit Management $1,400 115%
Benesys Inc $1,400 115%
Business Guarantor $1,400 115%
Chubb $1,400 115%
Commercial Sr. Care $1,400 115%
Employee Benefit Services $1,400 115%
Family Life Insurance Co $1,400 115%
Farm Bureau Insurance $1,400 115%
Fiserv Health Benefit $1,400 115%
Gmp $1,400 115%
Group And Pension Admin $1,400 115%
Group Resources $1,400 115%
Haik Minvielle And Grubbs $1,400 115%
Harrington Benefit Svs $1,400 115%
Health Design Plus $1,400 115%
Health Plan $1,400 115%
Healthscope Benefits $1,400 115%
Insurance Management Admi $1,400 115%
Jefferson National $1,400 115%
John Alden Health Ins $1,400 115%
John Hancock $1,400 115%
Liberty Mutual $1,400 115%
Mailhandlers Benefit Plan $1,400 115%
Manhattan Life Ins Co $1,400 115%
Mega Life And Health $1,400 115%
Msa Careguard $1,400 115%
Mutual Of Omaha $1,400 115%
Nalc Health Benefit Plan $1,400 115%
Naphcare Inc. $1,400 115%
New Era Life Ins Co $1,400 115%
Physicians Mutual $1,400 115%
Principal Financial Group $1,400 115%
Prudential Healthcare $1,400 115%
Self Pay $1,400 115%
State Farm $1,400 115%
State Farm Insurance $1,400 115%
State Mutual Insurance Co $1,400 115%
Sterling Investors Life $1,400 115%
Tower Life $1,400 115%
Transamerica Premier Ins $1,400 115%
United American $1,400 115%
United Comm Travelers $1,400 115%
United Teachers $1,400 115%
Usable Administrator $1,400 115%
Visn 16 Cfu $1,400 115%
Wausau Benefits $1,400 115%
Webtpa $1,400 115%
Wells Fargo $1,400 115%
Woodmen Of The World $1,400 115%
Blue Cross Blue Shield $2,435 199%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 620 East College Street, Homer, LA 71040
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals