CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Artesia General Hospital

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $589
Cash Discount Price: $384
vs. Medicare Baseline: 0.48x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Artesia General Hospital is $589. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $384. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 0.48x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$384

Average discount available for prompt cash payment at this facility.

Insurance Median

$589

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: $384 (31%)

Insurance Median: $589 (48%)

Cash: $384 (31% of Medicare)

Ins. Median: $589 (48% 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
Zelis	$175 - $1,371	14%
First Health	$247 - $576	20%
Blue Cross Blue Shield	$384 - $1,142	31%
Geha	$448 - $1,142	37%
Omni Networks	$448	37%
Three Rivers Provider Network	$480	39%
Cigna	$544 - $576	44%
Galaxy Health	$576	47%
One Health Plan	$576	47%
Multiplan	$582	48%
United Payors & United Providers	$595	49%
Providence Risk & Insurance Services	$608 - $2,285	50%
Molina Healthcare Of New Mexico	$744 - $1,919	61%
Presbyterian Health Plan	$744 - $1,142	61%
UnitedHealthcare	$744 - $1,142	61%
Triwest	$1,120	92%
Humana	$1,142 - $1,257	93%
Vistacare Hospice	$1,142	93%
New Mexico Health Connections	$1,942	159%

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 $384.
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 Artesia General Hospital 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.