CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Regional West Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,305
Cash Discount Price: $2,361
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Regional West Medical Center is $1,305. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,361. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.07x the Medicare baseline. Located in 4021 Ave B, Scottsbluff, NE.

Cash / Self-Pay

$2,361

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,305

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: $2,361 (193%)

Insurance Median: $1,305 (107%)

Cash: $2,361 (193% of Medicare)

Ins. Median: $1,305 (107% 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	$165 - $3,660	13%
Humana	$165 - $1,243	13%
Medica	$165 - $3,345	13%
Medica Cost	$174 - $1,305	14%
Wellcare	$174 - $1,305	14%
Naphcare	$248 - $1,864	20%
Winhealth	$314 - $3,345	26%
Ambetter / Centene	$389 - $1,864	32%
Cigna	$460 - $3,542	38%
Rci Insurance Group	$460 - $3,306	38%
UnitedHealthcare	$670 - $3,542	55%
Blue Cross Blue Shield	$803 - $3,148	66%

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 $2,361.
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 Regional West 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.