CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Mercy Health Saint Mary's

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $136
  • Cash Discount Price: $4,004
  • vs. Medicare Baseline: 0.11x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Mercy Health Saint Mary's is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,004. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.11x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$4,004

Average discount available for prompt cash payment at this facility.

Insurance Median
$136

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: $4,004 (328%)
Insurance Median: $136 (11%)
Cash: $4,004 (328% of Medicare)
Ins. Median: $136 (11% 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
Aetna $57 - $1,168 5%
Albany County Correctional Facility $57 5%
Ambetter / Centene $57 5%
Amish Mennonite $57 5%
Ascension St. Vincent Public Safety Medical $57 5%
Bccp $57 5%
Blue Cross Blue Shield $57 - $1,168 5%
Bmc Healthnet $57 5%
Breast Grant-Connecticut $57 5%
Broward County Dept Of Health $57 5%
California Health And Wellness $57 5%
Cardinal Innovations Lme $57 5%
Care Connections Of Northern Iowa $57 5%
Care Oregon Ohp $57 5%
Cencal Health Plan $57 5%
Cenpatico $57 5%
Chhuny $57 5%
Childrens Comm Health Plan $57 5%
Childrens Medical Services Title 19 $57 5%
Cigna $57 - $167 5%
City Of Philadelphia $57 5%
Cmh Allegan County $57 5%
Cmh Ausable Valley $57 5%
Cmh Barry County $57 5%
Cmh Bay-Arenac County $57 5%
Cmh Berrien County $57 5%
Cmh Cass County $57 5%
Cmh Central Mi County $57 5%
Cmh Clinton-Eaton-Ingham County $57 5%
Cmh Detroit Wayne Integrated Health Network $57 5%
Cmh Genesee County $57 5%
Cmh Ionia County $57 5%
Cmh Jackson County/Lifeways $57 5%
Cmh Kalamazoo $57 5%
Cmh Kent County $57 5%
Cmh Lenawee County $57 5%
Cmh Livingston County $57 5%
Cmh Macomb $57 5%
Cmh Misc $57 5%
Cmh Monroe County $57 5%
Cmh Montcalm County $57 5%
Cmh Muskegon County $57 5%
Cmh Newaygo County $57 5%
Cmh North Country $57 5%
Cmh Northern Lakes County $57 5%
Cmh Oakland County $57 5%
Cmh Ottawa County $57 5%
Cmh Van Buren County $57 5%
Cmh Washtenaw County $57 5%
Cmh Wayne County/Carelink $57 5%
Cmh Wayne Cty/Com Liv Svcs $57 5%
Cmh West Mi County $57 5%
Community Benefit Health $57 5%
Community Care Behavorial Health $57 5%
Community Care Partners $57 5%
Community Health Choice $57 5%
Connections Csp $57 5%
County Coroner $57 5%
County Funding Generic $57 5%
Covid19 Hrsa Uninsured Testing And Treatment Fund $57 5%
Dean Wi Badgercare $57 5%
Delaware County Department Of Health $57 5%
Delaware First Health $57 5%
Delta Dental Nj $57 5%
Dph Tb Program $57 5%
Dscc $57 5%
Eastpointe Lme $57 5%
Family Health Network $57 5%
Freedom First Healthcare $57 5%
Fresno County Ccs $57 5%
Ghc Scw Wi Badgercare $57 5%
Harbor Health $57 5%
Health Safety Net $57 5%
Healthy Blue Ne $57 5%
Hennepin Health $57 5%
Humana $57 - $388 5%
Id County Ada $57 5%
Id County Canyon $57 5%
Id County Cat Fund $57 5%
Id County Other $57 5%
Id County Payette $57 5%
Idaho Dept Health And Wellfare $57 5%
Idaho Womens Health Check $57 5%
Indiana Breast Cervical Cancer $57 5%
Inland Empire Health Plan $57 5%
Intercommunity Health Ohp $57 5%
Iowa Total Care $57 5%
Jai Medical System $57 5%
Kern Family Health Plan $57 5%
Keystone First $57 5%
Keystone First Chip $57 5%
La Care Health Plan $57 5%
Lakeland Care Inc $57 5%
Managed Health Services - Indiana $57 5%
Maryland Breast & Cervical Program $57 5%
Maryland Healthy Smiles - Scion Dental $57 5%
Maryland Physicians Care $57 5%
Massachusetts Behavioral Health Partnership $57 5%
Mdwise $57 5%
Medi-Cal $57 5%
Medi-Cal Healthnet $57 5%
Medicaid / KanCare $57 - $682 5%
Medstar Dc Healthy Family $57 5%
Medstar Md Health Choice $57 5%
Mo Home State Health Plan $57 5%
Molina Centennial Care $57 5%
Nascentia Health Options $57 5%
Nebraska Total Care $57 5%
New York Cancer Services Program $57 5%
Nextlevel Health $57 5%
Oregon Screenwise $57 5%
Pace Of Southwest Michigan $57 - $86 5%
Paramount Advantage $57 5%
Parkland Community Health Plan $57 5%
Partners Behavioral Lme $57 5%
Peach State Healthplan $57 5%
Philadelphia County Funding $57 5%
Presbyterian Centennial Care $57 5%
Prestige Health Choice $57 5%
Priority Partners $57 5%
Robert F Sing Program $57 5%
Rx 340B Pass Along $57 5%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $57 5%
Rx Medi-Cal $57 5%
Rx Meridian Rx $57 5%
Ryan White Florida Mssrp $57 5%
Sandhills Center Lme $57 5%
Screening For Life $57 5%
St Joseph County Hlth Dpt $57 5%
Stephenson Cty Health $57 5%
Sunshine State Health Plan $57 5%
Superior Health $57 5%
Tenncare $57 5%
Texas Children'S Health Plan $57 5%
Trillium Community Ohp $57 5%
Tufts Health Public Plans $57 5%
UnitedHealthcare $57 - $1,228 5%
Vaya Health Lme $57 5%
Washtenaw Health Plan $57 5%
Wellsense Health Plan $57 5%
Wi Womens Wellness $57 5%
Ally Align Care Adv $86 7%
American Health Advantage Of Idaho $86 7%
American Health Plan $86 7%
Aurora Special Needs $86 7%
Blue Care Network Advantage $86 - $1,168 7%
Blue Shield - De (Highmark) Medciare Advantage $86 7%
Care Dimensions $86 7%
Care Improvement Plus $86 7%
Care Resources Pace $86 7%
Careplus Health Plans $86 7%
Cca Senior Care Options $86 7%
Central Valley Medical Services Corp Pace $86 7%
Champion Health Plan Mcr Advantage $86 7%
Clear Spring Health $86 7%
Clover Health $86 7%
Commonwealth Care Alliance $86 7%
Community Pace At Home $86 7%
Eddy Senior Care-Pace $86 7%
Eddy Seniorcare Pace $86 7%
Elementcare $86 7%
Evercare $86 7%
Everence $86 7%
Gateway Health Plan $86 7%
Genesys Pace Of Genesee County $86 7%
Georgia Health Advantage $86 7%
Gold Advantage $86 7%
Gpa Croell Redi Mix $86 7%
Health America Advantra $86 7%
Highmark Health Options Dual Plan $86 7%
Hope Select Pace $86 7%
Horizon Nj Total Care $86 7%
Hudson Headwaters Pace $86 7%
Huron Valley Pace $86 7%
Innovative Integrated Health Community Plans $86 7%
Iowa Health Advantage $86 7%
Johns Hopkins Advantage Md $86 7%
Lasso Healthcare Msa $86 7%
Life St Marys Pace $86 7%
Lifecircles Pace $86 7%
Longevity Health Plan $86 7%
Martins Point Generations Advantage $86 7%
Mass General Brigham Mcr Adv $86 7%
Medicare (plans) $86 - $1,168 7%
Medipak Advantage $86 7%
Mercy Life $86 7%
Mercyone Cedar Valley $86 7%
Meridian Complete $86 7%
Michigan Complete Health $86 7%
Nascentia Health Plus $86 7%
New Centry Health Careplus $86 7%
Osu Prime Care Advantage $86 7%
Pace Cny $86 7%
Pace Iowa Immanuel Pathways $86 7%
Pace Southeast $86 7%
Pace-Trinity Health $86 7%
Peak Pace Solutions $86 7%
Perennial Advantage $86 7%
Preferred Care Partners $86 7%
Presbyterian Senior Plan $86 7%
Provider Partners Health Plan Of Illinois $86 7%
Provider Partners Health Plan Of Indiana $86 7%
Pruitthealth Premier $86 7%
Reliance Community Care Partners Care Resources Pace $86 7%
Rx Allwin $86 7%
Rx Grane Grnmedd $86 7%
Rx Retiree Rx Care $86 7%
Scan Health Plan Mcr Ipa Meritage Oon $86 7%
Secure Horizons Ma Pffs $86 7%
Serenity Pace $86 7%
Siouxland Pace $86 7%
Solis Health Plans $86 7%
Sunnyview-Pace Finance Dept $86 7%
Texan Plus $86 7%
The Health Plan $86 - $388 7%
Thome Pace $86 7%
Todays Options $86 7%
Tribute Health Plans $86 7%
Um Health Advantage $86 7%
Union Health Service $86 7%
Welbe Health $86 7%
Wellmed $86 7%
Align Senior Care $88 - $1,192 7%
Veterans Administration $88 7%
Champva $93 8%
Tricare $93 8%
Triwest Health Alliance $93 8%
Us Family Health Plan $93 8%
Veterans Eval Services $93 8%
Cca - Zing Health $95 8%
Access Health $98 - $835 8%
Longevity Ipa Of Michigan Llc Health Plan Isnp $99 - $1,344 8%
1199 National Benefit Fund $118 10%
Allied National Global Care $118 10%
Asrm - Reliance Standard Life Insurance $118 10%
Christian Care Ministry $118 10%
Dean Health $118 10%
Fallon Health $118 10%
Family Life Insurance Company $118 10%
International Benefit Administrators $118 10%
Lifetime Benefit Solutions $118 10%
Manhattan Life $118 10%
Molina Marketplace $118 - $1,550 10%
Multiplan $118 10%
Mvp $118 10%
Oscar $118 - $1,526 10%
Pai $118 10%
Pan-American Life $118 10%
Phcs $118 10%
Trinity Health Share $118 10%
Wellpath $118 - $1,848 10%
Partners Direct Health - Brio $127 10%
Claimdoc $136 11%
Kent County Jail $136 11%
Muskegon County Jail $136 11%
Nomi Health $136 11%
Wc Accident Fund $143 12%
Wc Advantage $143 12%
Wc Aig $143 12%
Wc Allied $143 12%
Wc Amerisure $143 12%
Wc Amtrust $143 12%
Wc Asu Risk Mgt $143 12%
Wc Berkley Admin $143 12%
Wc Broadspire $143 12%
Wc Bunch & Associates $143 12%
Wc Ccmsi $143 12%
Wc Emc Insurance Company $143 12%
Wc Esis $143 12%
Wc Fcci $143 12%
Wc Federated $143 12%
Wc Gallagher Bassett $143 12%
Wc Genex Care For Ohio $143 12%
Wc Guard Insurance Company $143 12%
Wc Hartford $143 12%
Wc Liberty Mutual $143 12%
Wc Meijers $143 12%
Wc Michigan $143 12%
Wc Mitchell Frankenmuth $143 12%
Wc Pma $143 12%
Wc Sedgwick $143 12%
Wc Sentry $143 12%
Wc Travelers $143 12%
Wc Tristar $143 12%
Wc Walmart $143 12%
Wc Zurich $143 12%
Andrie Inc $150 12%
East Greenbush Central School District $150 12%
Genex Wc $150 12%
Healthsmart Workers Comp $150 12%
Jag Source $150 12%
New York State Insurance Fund $150 12%
Njm Insurance Group $150 12%
Rx Heatlhcomp $150 12%
Rx Restat $150 12%
Rx Saif Opdp Wc $150 12%
Rx Worker'S Comp $150 12%
Wc Ace $150 12%
Wc Acs Federal Employees $150 12%
Wc Acuity $150 12%
Wc Aegis $150 12%
Wc Aims $150 12%
Wc Alaska National Ins $150 12%
Wc Align Network $150 12%
Wc Am Trust N America $150 12%
Wc American Claims Mgmt $150 12%
Wc Benetech $150 12%
Wc Broward County $150 12%
Wc California State Comp Ins $150 12%
Wc California State Ins Fund $150 12%
Wc Capitol Area Health Consortium $150 12%
Wc Chartis $150 12%
Wc Chubb $150 12%
Wc Cirma $150 12%
Wc City Of Albany $150 12%
Wc City Of Sioux City $150 12%
Wc Claims Mgmt Inc $150 12%
Wc Cna $150 12%
Wc Comp One Admin C/O Manageability $150 12%
Wc Compone Admin $150 12%
Wc Corvel $150 12%
Wc Ct Healthcare Trust $150 12%
Wc Donegal Insurance Group $150 12%
Wc Employee Mutual $150 12%
Wc Enablecomp $150 12%
Wc Encore Health Network $150 12%
Wc Erie $150 12%
Wc Evolutions $150 12%
Wc Fed Ex $150 12%
Wc Federal Black Lung $150 12%
Wc Finley Occupational Health $150 12%
Wc First Agency/Occunet $150 12%
Wc Ford Motor $150 12%
Wc Fresno Unified Emp $150 12%
Wc General Motors $150 12%
Wc Generic $150 12%
Wc Great West Casualty $150 12%
Wc Guarantee Insurance $150 12%
Wc Hab $150 12%
Wc Hastings $150 12%
Wc Health Management $150 12%
Wc Heritage Summit $150 12%
Wc Hireright $150 12%
Wc Horizon $150 12%
Wc Icw Group $150 12%
Wc Idaho State Ins Fund $150 12%
Wc Intercare Insurance $150 12%
Wc Intermountain $150 12%
Wc Johns Eastern $150 12%
Wc Kemberton $150 12%
Wc Key Ins & Benefit Solutions $150 12%
Wc Mac Risk Management $150 12%
Wc Massachusetts $150 12%
Wc Mdia $150 12%
Wc Meadowbrook Claim $150 12%
Wc Medical Administrators $150 12%
Wc Memic $150 12%
Wc Mercy Workcare $150 12%
Wc Michigan Millers Mutual $150 12%
Wc Mra $150 12%
Wc Nationwide $150 12%
Wc Nca Comp $150 12%
Wc New York $150 12%
Wc New York Special Funds $150 12%
Wc North American Rishces $150 12%
Wc Northeast Health $150 12%
Wc Notre Dame $150 12%
Wc Novanet $150 12%
Wc O'Hara Corp $150 12%
Wc Occ Health Allen $150 12%
Wc Ohio Bureau $150 12%
Wc One Call Medical $150 12%
Wc Paradigm $150 12%
Wc Peerless $150 12%
Wc Praxis Health Network $150 12%
Wc Price Chopper $150 12%
Wc Procura Management $150 12%
Wc Qualcare $150 12%
Wc Quiktrip $150 12%
Wc Reny Company $150 12%
Wc Rev Claims $150 12%
Wc Risico $150 12%
Wc Rural Mutual $150 12%
Wc Saif Oregon $150 12%
Wc Secura $150 12%
Wc Sheakley Unicomp $150 12%
Wc Smile Lodge $150 12%
Wc Society $150 12%
Wc Srs $150 12%
Wc Taconic (Mro) $150 12%
Wc Taconic Farms $150 12%
Wc Triad Group $150 12%
Wc Troy Ny $150 12%
Wc Tyson $150 12%
Wc Unified Health Services $150 12%
Wc United Heartland $150 12%
Wc Us Dept Of Labor $150 12%
Wc Velocity $150 12%
Wc West Bend $150 12%
Wc West Bend Mutual/Argent $150 12%
Wc Winnebago Industries $150 12%
Wc Yankee Trails $150 12%
Wc York Risk $150 12%
Wc Zenith $150 12%
Blue Care Network $151 - $1,016 12%
Blue Benefit Administrators Of Massachusetts $159 - $1,016 13%
Blue Distinction Transplant $159 - $1,016 13%
Blue Shield - Ca $159 - $1,016 13%
Blue Shield - Id (Regence) $159 - $1,016 13%
Blue Shield - Ny Highmark Northeastern $159 - $1,016 13%
Blue Shield - Ny Highmark Western $159 - $1,016 13%
Blue Shield - Pa (Highmark) $159 - $1,016 13%
Blue Shield - Wa (Regence) $159 - $1,016 13%
Geha $164 13%
American Postal Workers Secondary $167 14%
Priority Health $177 - $2,202 14%
Hap $182 - $251 15%
Varipro $182 15%
Us Health And Life $195 16%
Asr Health Benefits $213 17%
U Of M Health Plan $221 - $882 18%
Meritain $239 20%
Health Partners $251 21%
Tufts Health Plan $251 21%
Bcccp-Michigan $252 - $334 21%
Acclaim $292 - $388 24%
Administrative Concepts $292 - $388 24%
Allegeant $292 - $388 24%
Allied Benefit Systems $292 - $388 24%
Ameriben $292 - $388 24%
American Family $292 - $388 24%
American Healthcare Alliance $292 - $388 24%
American National $292 - $388 24%
American Republic $292 - $388 24%
Amerihealth $292 - $388 24%
Aultcare $292 - $388 24%
Automated Benefit Services $292 - $388 24%
Auxiant $292 - $388 24%
Benefit Administrative Systems,Llc $292 - $388 24%
Boon Chapman $292 - $388 24%
Cam Administrative Services $292 - $388 24%
Christian Brother Services $292 - $388 24%
Christian Brothers Holy Cross $292 - $388 24%
Claimchoice Adminstrators $292 - $388 24%
Comprehensive Benefits $292 - $388 24%
Consociate $292 - $388 24%
Continental Life Insurance $292 - $388 24%
Coventry $292 - $388 24%
Custom Benefit Administrators $292 - $388 24%
Cypress Benefit Administrators $292 - $388 24%
Employee Benefit Concepts $292 - $388 24%
Employee Benefit Management $292 - $388 24%
Enterprise Group Planning $292 - $388 24%
First Health $292 - $388 24%
Forest County Potawatomi $292 - $388 24%
Freedom Life Insurance Company $292 - $388 24%
Group Administrators $292 - $388 24%
Group Marketing Services $292 - $388 24%
Group Pension Administrators $292 - $388 24%
Guardian $292 - $388 24%
Health America $292 - $388 24%
Health Choices $292 - $1,016 24%
Health Smart $292 - $388 24%
Healthcare Management Admin $292 - $388 24%
Healthez $292 - $388 24%
Healthgram $292 - $388 24%
Healthscope $292 - $388 24%
Insight $292 - $388 24%
Jfp Benefit Management $292 - $388 24%
Jp Farley Corporation $292 - $388 24%
Key Benefit Administrator $292 - $388 24%
Liberty Union Life Assurance Co $292 - $388 24%
Lucent Health $292 - $388 24%
Luminare Health $292 - $388 24%
Luminare Health (Detroit) $292 - $388 24%
Magnacare $292 - $388 24%
Medben $292 - $388 24%
Medcost $292 - $388 24%
Medical Mutual $292 - $388 24%
Mutual Health Services $292 - $388 24%
Mutual Of Omaha $292 - $388 24%
Ncas $292 - $388 24%
Nippon Life Ins $292 - $388 24%
Nova $292 - $388 24%
Painters Union Insurance Fund $292 - $388 24%
Physicians Mutual $292 - $388 24%
Plumbers Local 98 Insurance Fund $292 - $388 24%
Prairie States $292 - $388 24%
Preferred One $292 - $388 24%
Primary Physician Care $292 - $388 24%
Professional Benefit Administrators $292 - $388 24%
Secureone Preferred United Plans $292 - $388 24%
Siho Insurance Services $292 - $388 24%
Sisco Benefits $292 - $388 24%
The Loomis Company $292 - $388 24%
Trustmark Small Business Benefits $292 - $388 24%
Unicare $292 - $388 24%
Unified Group Services $292 - $388 24%
Valenz $292 - $388 24%
Webtpa $292 - $388 24%
Western & Southern Financial Group $292 - $388 24%
Wps $292 - $388 24%
Bcn Domestic $1,016 83%
Kaiser Domestic $1,016 83%
Correctional Recovery $1,192 98%
Hospice Faith $1,192 98%
Hospice Of Holland $1,192 98%
Vitalcore $1,848 151%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Jefferson Avenue Se, Grand Rapids, MI 49503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals