CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Magee General Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,124
Cash Discount Price: $2,353
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Magee General Hospital is $1,124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,353. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.92x the Medicare baseline. Located in 300 3Rd Ave Se, Magee, MS.

Cash / Self-Pay

$2,353

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,124

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: $2,353 (192%)

Insurance Median: $1,124 (92%)

Cash: $2,353 (192% of Medicare)

Ins. Median: $1,124 (92% 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
Blue Cross Blue Shield	$666	54%
Mississippi State Employees And Teachers	$666	54%
Magnolia Health Plan Mcd Rep	$860	70%
Medicaid / KanCare	$860	70%
Mississippi Childrens Health Insurance Program	$860	70%
Molina Healthcare Of Ms Mcd Adv	$860	70%
UnitedHealthcare	$860 - $1,124	70%
Aetna	$1,124	92%
Ambetter / Centene	$1,124	92%
Harmony Health Plan Of Illinois	$1,124	92%
Humana	$1,124	92%
Medicare (plans)	$1,124	92%
Shared Health Mississippi Mcr Adv	$1,124	92%
Vantage Health Plan Inc Mcr Adv Primewell Health	$1,124	92%
Wellcare Health Plan Inc Mcr Adv	$1,124	92%

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 $2,353.
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 Magee General 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.