CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Holland Community Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $354
Cash Discount Price: $228
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Holland Community Hospital is $354. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.29x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$228

Average discount available for prompt cash payment at this facility.

Insurance Median

$354

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: $228 (19%)

Insurance Median: $354 (29%)

Cash: $228 (19% of Medicare)

Ins. Median: $354 (29% 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
UnitedHealthcare	$50 - $657	4%
Nomi Health - All Plans	$84	7%
Life Circles-All Plans	$167	14%
Health Alliance Mcr Adv	$175	14%
Ph Mcr Adv	$175	14%
Va Ccn - All Plans	$175	14%
Aetna	$181 - $649	15%
Longevity Health Plan-All Plans	$189	15%
First Health-All Plans	$228	19%
Benefit Source Inc-All Plans	$304	25%
Blue Cross Blue Shield	$317	26%
Multiplan - All Plans	$342	28%
Cigna	$346	28%
Priority Health - All Other Plans	$362	30%
Sisco-All Other Plans	$453	37%
Asr - All Plans	$507	41%
Health Alliance Ahl - All Other Plans	$507	41%
Health Alliance Hmo	$507	41%
Blue Care Network - All Plans	$638	52%
Cofinity -All Plans	$649	53%
Meridian Mcaid Profee Only-All Plans	$657	54%
Molina Mcaid - All Plans	$657	54%
Ph Mcaid	$657	54%
Sisco Epi	$1,125	92%

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 $228.
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 Holland Community 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.