CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Methodist Fremont Health

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,481
Cash Discount Price: $882
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Methodist Fremont Health is $1,481. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $882. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.21x the Medicare baseline. Located in 450 East 23Rd St, Fremont, NE.

Cash / Self-Pay

$882

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,481

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: $882 (72%)

Insurance Median: $1,481 (121%)

Cash: $882 (72% of Medicare)

Ins. Median: $1,481 (121% 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
Elevate By Medica	$280 - $1,387	23%
Medica	$297 - $1,310	24%
Medicare (plans)	$297 - $1,336	24%
Alliance Nhn	$330 - $1,794	27%
Medica Choice	$330 - $2,712	27%
Aetna	$396 - $2,959	32%
Ne Furniture Mart	$396 - $2,558	32%
UnitedHealthcare	$396 - $2,777	32%
Blue Cross Blue Shield	$429 - $2,758	35%
Multiplan	$594 - $2,774	49%
Ambetter / Centene	$649 - $2,711	53%
Elite Choice	$660 - $2,715	54%
Midlands Choice	$660 - $2,897	54%
Humana	$1,310	107%

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 $882.
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 Methodist Fremont Health 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.