CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Astera Health

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $430
Cash Discount Price: $928
vs. Medicare Baseline: 0.35x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Astera Health is $430. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $928. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.35x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$928

Average discount available for prompt cash payment at this facility.

Insurance Median

$430

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: $928 (76%)

Insurance Median: $430 (35%)

Cash: $928 (76% of Medicare)

Ins. Median: $430 (35% 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
Ucare Pmap [30006]	$138 - $3,282	11%
Blue Plus Pmap [40002]	$142 - $2,292	12%
Health Partners Pmap [10046]	$142 - $4,535	12%
Medica Pmap [10057]	$142 - $3,363	12%
Primewest Pmap [30003]	$142 - $3,363	12%
UnitedHealthcare	$262 - $6,969	21%
Health Partners [10045]	$318 - $6,446	26%
Medica Nonpmap [10056]	$340 - $100,107	28%
Blue Cross Blue Shield	$411 - $4,583	34%
Primewest Non Pmap [30004]	$411	34%
Ucare Non Pmap [30007]	$411 - $3,786	34%
Sanford Health Plan [10120]	$637 - $809	52%
Ucare Commercial [10705]	$955 - $6,702	78%
Multiplan	$1,028 - $7,212	84%
Aetna	$1,157 - $8,114	95%

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 $928.
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 Astera Health 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.