Colonoscopy with biopsy
Facility: Liberty Hospital
Billing Code: 45380 (CPT)
- CPT Billing Code: 45380
- Insurance Median: $1,433
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.17x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $204 - $5,142 | 17% |
| Cigna | $732 - $1,047 | 60% |
| Aetna | $1,047 - $3,680 | 86% |
| UnitedHealthcare | $1,047 - $1,728 | 86% |
| Medicare (plans) | $1,058 - $1,152 | 87% |
| Humana | $1,068 - $4,497 | 87% |
| Healthy Blue | $1,124 | 92% |
| Ambetter / Centene | $1,330 | 109% |
| Home State Health | $1,537 | 126% |
Consumer Guidance & Cost Commentary
For a Colonoscopy with biopsy at Liberty Hospital in Liberty, Missouri, the median negotiated rate is $1,433. This facility, a voluntary non-profit acute care hospital, has a facility rating of 2 and serves patients across 9 payers. While the data does not provide a specific cash or median paid rate for this procedure, the median negotiated rate of $1,433 is significantly higher than the Medicare amount of $1,222.56, reflecting a markup ratio of 1.2 times the Medicare benchmark.
Patients should be aware that cash-pay options or prompt-pay discounts may offer lower costs than the standard negotiated rate, particularly for those with high-deductible plans where the insurance allowed amount exceeds the cash price. Although the facility is in-network for major carriers like Blue Cross Blue Shield, Cigna, and Aetna, with negotiated rates ranging from $732 to $5,142 depending on the plan, it is crucial to request an itemized bill before paying to identify any errors, unbundled codes, or services not rendered. Additionally, patients should verify if "self-pay" or "prompt-pay" discounts are available prior to scheduling, as these upfront payment incentives can bypass the administrative overhead included in the insurance negotiated rate.