CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Fairview Bethesda Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,704
Cash Discount Price: $1,131
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Fairview Bethesda Hospital is $1,704. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,131. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.39x the Medicare baseline. Located in 45 10Th St W, Saint Paul, MN.

Cash / Self-Pay

$1,131

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,704

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: $1,131 (93%)

Insurance Median: $1,704 (139%)

Cash: $1,131 (93% of Medicare)

Ins. Median: $1,704 (139% 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
Health Partners	$133 - $2,787	11%
Itasca Medical Care	$133 - $1,174	11%
Primewest	$133 - $1,174	11%
South Country Health Alliance	$133 - $1,174	11%
Ucare	$136 - $2,697	11%
Medica	$143 - $2,588	12%
Hennepin Health	$151 - $1,188	12%
Blue Cross Blue Shield	$153 - $2,109	13%
Sanford Health Plan	$181 - $2,108	15%
Security Health Plan	$181 - $2,684	15%
UnitedHealthcare	$181 - $2,044	15%
Wellcare	$181 - $1,174	15%
America'S Ppo	$1,406 - $2,577	115%
First Health	$2,213 - $2,935	181%
Multiplan	$2,294 - $3,042	188%
Private Healthcare Systems	$2,294 - $3,042	188%
Wisconsin Physician Services	$2,429 - $3,221	199%

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 $1,131.
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 Fairview Bethesda 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.