CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Olivia Hospital & Clinic

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,004
Cash Discount Price: $1,354
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Olivia Hospital & Clinic is $1,004. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,354. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.82x the Medicare baseline. Located in 100 Healthy Way, Olivia, MN.

Cash / Self-Pay

$1,354

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,004

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: $1,354 (111%)

Insurance Median: $1,004 (82%)

Cash: $1,354 (111% of Medicare)

Ins. Median: $1,004 (82% 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
Medicare (plans)	$217 - $1,004	18%
Blue Cross Blue Shield	$220 - $3,574	18%
UnitedHealthcare	$224 - $2,817	18%
Medicaid / KanCare	$226 - $1,288	18%
Healthpartners [900713]	$1,392 - $2,481	114%
Medica [900156]	$1,527 - $2,722	125%
First Health Network [950334]	$1,548 - $2,759	127%

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 $1,354.
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 Olivia Hospital & Clinic 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.