CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Harrison County Community Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $232
Cash Discount Price: $419
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Harrison County Community Hospital is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $419. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.19x the Medicare baseline. Located in 2600 Miller Street, Bethany, MO.

Cash / Self-Pay

$419

Average discount available for prompt cash payment at this facility.

Insurance Median

$232

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: $419 (34%)

Insurance Median: $232 (19%)

Cash: $419 (34% of Medicare)

Ins. Median: $232 (19% 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
Aetna	$147 - $1,813	12%
Allwell	$150 - $1,195	12%
Ambetter / Centene	$150 - $1,195	12%
Blue Advantage Plus	$150 - $1,195	12%
Care Improvement Plus	$150 - $1,195	12%
Humana	$150 - $1,854	12%
UnitedHealthcare	$150 - $1,751	12%
Provider Partners Health Plans	$162 - $1,290	13%
Blue Cross Blue Shield	$165 - $1,813	13%
Multiplan	$176 - $1,648	14%
Cigna	$184 - $1,648	15%
6 Degrees Health	$206 - $1,648	17%
Wellmark	$206 - $1,648	17%
Healthy Blue	$1,288 - $1,310	105%
Home State	$1,288 - $1,310	105%

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 $419.
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 Harrison County Community 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.