CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Frye Regional Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $762
Cash Discount Price: $1,368
vs. Medicare Baseline: 0.62x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Frye Regional Medical Center is $762. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,368. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.62x the Medicare baseline. Located in 420 N Center St, Hickory, NC.

Cash / Self-Pay

$1,368

Average discount available for prompt cash payment at this facility.

Insurance Median

$762

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: $1,368 (112%)

Insurance Median: $762 (62%)

Cash: $1,368 (112% of Medicare)

Ins. Median: $762 (62% 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	$210 - $762	17%
Aetna	$225 - $1,129	18%
UnitedHealthcare	$343 - $5,073	28%
Vaya Health	$542	44%
Carolina Complete Health Inc.	$549	45%
Humana	$554 - $1,107	45%
Cigna	$574 - $1,395	47%
Amerihealth Caritas North Carolina	$745	61%
Wellcare Of North Carolina, Inc	$748	61%
Vanguard Furniture	$928	76%
Rhf Investments	$989	81%
Partners Health Management	$1,131	93%
Sherrill Furniture	$1,290	106%
Ambetter / Centene	$1,444	118%

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 $1,368.
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 Frye Regional Medical Center 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.