CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Rehoboth McKinley Christian Health Care Services

Billing Code: 45380 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 45380
Insurance Median: $1,230
Cash Discount Price: $447
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Colonoscopy with biopsy at Rehoboth McKinley Christian Health Care Services is $1,230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $447. Compared to the federal Medicare reimbursement reference rate of $1,222.56, this hospital’s rate is 1.01x the Medicare baseline. Located in 1901 Red Rock Drive, Gallup, NM.

Cash / Self-Pay

$447

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,230

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: $447 (37%)

Insurance Median: $1,230 (101%)

Cash: $447 (37% of Medicare)

Ins. Median: $1,230 (101% 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
Medicare (plans)	$358	29%
Triwest	$358	29%
Usa	$393	32%
Coventry	$894	73%
UnitedHealthcare	$1,118	91%
Health West	$1,192	98%
Three Rivers	$1,192	98%
Blue Cross Blue Shield	$1,267	104%
Integrated Health	$1,267	104%
Humana	$1,341	110%
Multiplan	$1,341	110%
Cigna	$1,386	113%
Presbyterian	$1,386	113%
Associated Plan Administrators	$1,416	116%

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 $447.
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 Rehoboth McKinley Christian Health Care Services 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.