CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Columbus Regional Healthcare System

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,363
Cash Discount Price: $1,606
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Columbus Regional Healthcare System is $1,363. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,606. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.11x the Medicare baseline. Located in 500 Jefferson St, Whiteville, NC.

Cash / Self-Pay

$1,606

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,363

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: $1,606 (131%)

Insurance Median: $1,363 (111%)

Cash: $1,606 (131% of Medicare)

Ins. Median: $1,363 (111% 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
Alliance	$512	42%
Amerihealth	$512	42%
Apex Health	$512	42%
Cardinal	$512	42%
Carolina Complete Health	$512	42%
Healthy Blue	$512	42%
Partners	$512	42%
Sandhills	$512	42%
Trillium	$512	42%
UnitedHealthcare	$512 - $1,560	42%
Wellcare	$512 - $1,106	42%
Molina	$589 - $946	48%
Blue Cross Blue Shield	$998 - $1,473	82%
Troy	$1,106	90%
Va Communicare Care	$1,106	90%
Vaya Health	$1,117	91%
Liberty	$1,128	92%
Humana	$1,139	93%
Aetna	$1,145 - $2,225	94%
Devoted Health	$1,150	94%
Cigna	$1,161 - $2,179	95%
Queens University	$1,262	103%
Ambetter / Centene	$1,335 - $1,553	109%
Oscar	$1,491 - $1,675	122%
Employers Health Network	$1,521 - $1,700	124%
Quicktrip	$1,835	150%
Multiplan	$2,064 - $2,179	169%
Choicecare	$2,179	178%
Healthgram	$2,179	178%
Medcost	$2,179	178%

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 $1,606.
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 Columbus Regional Healthcare System 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.