CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Howard County Medical Center

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45380
  • Insurance Median: $235
  • Cash Discount Price: $892
  • vs. Medicare Baseline: 0.19x Medicare
The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Howard County Medical Center is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $892. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.19x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.
Cash / Self-Pay
$892

Average discount available for prompt cash payment at this facility.

Insurance Median
$235

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: $892 (73%)
Insurance Median: $235 (19%)
Cash: $892 (73% of Medicare)
Ins. Median: $235 (19% 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.

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
Humana $150 - $177 12%
Aetna $177 - $506 14%
Blue Cross Blue Shield $177 - $1,862 14%
Great Plains $177 14%
Medica Chi $177 14%
Tricare $177 14%
UnitedHealthcare $177 - $731 14%
Medica Standard Premier $179 15%
Medica Elevate $181 - $350 15%
Nebraska Total Care - Wellcare $182 15%
Molina Healthcare $186 - $237 15%
Nebraska Total Care $232 19%
Oscar Health $310 25%
Ambetter / Centene $354 29%
Beshp $354 29%
Medica Ifb Aco $356 29%
Medica Chi Aco $368 30%
Medica Choice National $393 32%
Medica Ifb Open Access $455 37%
Midland'S Choice $805 66%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: P O Box 406, 1113 Sherman St, St Paul, NE 68873
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals