CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Poplar Bluff Regional Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $1,605
  • Cash Discount Price: $6,649
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Poplar Bluff Regional Medical Center is $1,605. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,649. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.31x the Medicare baseline. Located in 3100 Oak Grove Road, Poplar Bluff, MO.
Cash / Self-Pay
$6,649

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,605

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: $6,649 (544%)
Insurance Median: $1,605 (131%)
Cash: $6,649 (544% of Medicare)
Ins. Median: $1,605 (131% 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
Medicaid / KanCare $250 - $6,332 20%
Veterans Eval Services $374 31%
Blue Cross Blue Shield $1,101 - $8,200 90%
Node Champva $1,209 99%
Tricare $1,209 99%
Medicare (plans) $1,263 103%
Node United Behavioral Health Mcr Adv $1,263 103%
Humana $1,276 104%
Node Hospice Non Par Agree $1,284 105%
Node Va $1,284 105%
UnitedHealthcare $1,284 - $17,034 105%
Node Ahs Mcr Adv $1,314 107%
Node Devoted Health Mcr Adv $1,326 108%
Node Pphp Mcr Adv $1,453 119%
Centurion Correctional $1,605 131%
Us Department Of Labor $1,605 131%
Naphcare $2,439 199%
Home State Exchange $3,209 262%
W W Wood $3,209 262%
Blue Access $4,262 349%
Self Pay $7,599 622%
Cigna $17,161 - $25,330 1404%
Evolutions Healthcare $17,256 1411%
Tyson Foods $17,414 1424%
Access Health Services, Llc $18,047 1476%
First Health $18,997 1554%
Healthlink $19,789 1619%
Parker Hannifin $22,163 1813%
Blue Traditional $23,417 1915%
Coventry Wc $25,330 2072%
Municipal Health $25,330 2072%
Multiplan $27,546 2253%
Phcs $27,546 2253%
Compresults Wc $28,496 2331%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Oak Grove Road, Poplar Bluff, MO 63901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals