CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Ochsner St Anne General Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,819
Cash Discount Price: $1,067
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Ochsner St Anne General Hospital is $1,819. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,067. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.49x the Medicare baseline. Located in 4608 Highway 1, Raceland, LA.

Cash / Self-Pay

$1,067

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,819

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: $1,067 (87%)

Insurance Median: $1,819 (149%)

Cash: $1,067 (87% of Medicare)

Ins. Median: $1,819 (149% 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
Humana	$468 - $752	38%
UnitedHealthcare	$468 - $4,516	38%
Healthy Blue (Healthy Louisiana)	$478	39%
Louisiana Healthcare Connections (Healthy Louisiana)	$478	39%
Aetna	$482 - $3,593	39%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$482	39%
Tricare	$675 - $750	55%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$752	62%
Blue Cross Blue Shield	$752 - $3,101	62%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$752	62%
Medicare (plans)	$752	62%
Ochsner Health Plan	$752	62%
Medicaid / KanCare	$874	71%
Healthcomp & Personify Health (Formerly Gilsbar)	$1,819	149%
Louisiana Workers' Compensation Corporation (Lwcc)	$1,819	149%
Mississippi Physicians Care Network	$1,819	149%
Employers Health Network (Ehn)	$2,061	169%
First Health Network	$2,061	169%
Prime Health Services Ppo	$2,061	169%
Claritev D/B/A Multiplan/Phcs/American Life Care	$2,182	178%
Usa Managed Care Network	$2,182	178%
Zelis	$2,182	178%
Cigna	$2,321	190%

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 $1,067.
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 St Anne General 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.