CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Womans Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $2,527
Cash Discount Price: $4,100
vs. Medicare Baseline: 2.07x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Womans Hospital is $2,527. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,100. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 2.07x the Medicare baseline. Located in 100 Woman's Way, Baton Rouge, LA.

Cash / Self-Pay

$4,100

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,527

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: $4,100 (335%)

Insurance Median: $2,527 (207%)

Cash: $4,100 (335% of Medicare)

Ins. Median: $2,527 (207% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 207% of the Medicare baseline (a markup of 107%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Webtpa [100127]	$1,895 - $2,480	155%
Fmolhs Employees [100257]	$2,211	181%
UnitedHealthcare	$2,338 - $2,527	191%
Blue Cross Blue Shield	$2,480	203%
La Women'S Healthcare [100265]	$2,480	203%
Verity [100266]	$2,480	203%
Aetna	$2,527 - $2,969	207%
Cigna	$2,527 - $2,622	207%
Coventry [100010]	$2,527	207%
Ppo Plus [100259]	$2,527	207%
Beech Street [100260]	$2,685	220%
Multiplan [100258]	$2,780	227%
Private Health [100261]	$2,780	227%
Humana	$2,969	243%
Meritain [100063]	$2,969	243%

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 $4,100.
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 Womans Hospital 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.