CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Greater Baltimore Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $463
Cash Discount Price: $888
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Greater Baltimore Medical Center is $463. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $888. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.38x the Medicare baseline. Located in 6701 North Charles Street, Baltimore, MD.

Cash / Self-Pay

$888

Average discount available for prompt cash payment at this facility.

Insurance Median

$463

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: $888 (73%)

Insurance Median: $463 (38%)

Cash: $888 (73% of Medicare)

Ins. Median: $463 (38% 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
Aetna	$357 - $558	29%
Md Physician Care [237]	$357	29%
Medicaid / KanCare	$357	29%
Priority Partners [241]	$357	29%
UnitedHealthcare	$357 - $638	29%
Wellpoint [235]	$357	29%
Alterwood Health [290]	$364	30%
Jai Medical Services [236]	$375	31%
Carefirst Maryland Health Advantage Mca [264]	$463	38%
Carefirst [201]	$463 - $899	38%
Cfchp Mco [239]	$463	38%
Cigna	$463 - $749	38%
Communicare Advantage [300]	$463	38%
Humana	$463	38%
Johns Hopkins [213]	$463 - $620	38%
Keycare Advantage [299]	$463	38%
Medicare (plans)	$463	38%
Multiplan/Phcs [296]	$463 - $601	38%
Provider Partners Health Plan [298]	$463	38%
First Health Network [268]	$601	49%
Kaiser Permanente Hmo [231]	$634 - $652	52%
Carefirst Blue Choice Hmo [253]	$650 - $826	53%
Carefirst Administrator [252]	$707 - $899	58%
Usa Managed Care Organization [301]	$708	58%

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 $888.
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 Greater Baltimore Medical Center 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.